Context

There is extremely wide geographical variation in the organisation of out-of-hours dental services provided in the United Kingdom. In many parts of the UK there are no formal out-of-hours care arrangements for unregistered patients, even at weekends.

One study has shown that on weekday nights over two-thirds of UK health authorities have no formal arrangements for unregistered patients. At the weekend just under half have separate arrangements for registered and unregistered patients, and one-fifth have no formal dental care arrangement at all [1].

It is little wonder in this confusing time, patients with dental emergencies attend the emergency department (ED), as they feel they have nowhere else to turn. In fact, presentations of non-traumatic dental problems can account for between 0.3% and 0.5% of ED attendances [2].

A separate study has shown that while junior doctors in the ED are seeing dental problems on an almost weekly basis, up to half of juniors have had no formal training in examination of the mouth, are unable to identify the timings of deciduous and permanent teeth eruptions and only 29% could describe the optimal management of a dental infection [3].

Learning bite

Although dental problems are a common presentation, junior doctors in the ED have inadequate knowledge and are poorly prepared to deal with the most common problems encountered.