Professional knowledge of accident and emergency doctors on the management of dental injuries.

BACKGROUND: Accident and emergency (A&E) doctors are often the first to assess dental and dento-alveolar injuries. Early diagnosis and appropriate management is essential for a good long-term prognosis of restored dental aesthetics and function. OBJECTIVE: To evaluate A&E doctors' knowledge of the management of dental injuries, and appropriate onward referral. DESIGN AND SETTING: A cross-sectional survey using a questionnaire sent to A&E doctors of all grades at all nine A&E hospitals in South Wales over a consecutive five-month period. METHOD: Data relating to the level of knowledge of emergency management of dental trauma were analysed. The relationship between doctor's level of experience and previous training received on the management of common dento-alveolar trauma was considered. Data were analysed for Pearson correlation coefficients. RESULTS: The response rate to the questionnaire was 72% (n = 118). There was a negligible correlation between the career grade of the doctors and their knowledge of the management of dental injuries (r = 0.128, p < 0.001). A strong positive linear correlation (r = 0.928, p < 0.001) was found between those with prior training and their knowledge of dental injury management. CONCLUSIONS: The findings from this study suggest that A&E doctors have only partial knowledge of the management of dental injuries, though appropriate training can significantly increase knowledge.

Predicting children's behaviour during dental treatment under oral sedation.

AIMS: The primary aim of this study was to assess whether parents' own anxiety and their perception of their child's dental fear and child's general fear can predict preoperatively their child's behaviour during dental treatment under oral sedation. The secondary aim was to assess whether the child's age, gender and ASA classification grade are associated with a child's behaviour under oral sedation. STUDY DESIGN: Cross-sectional prospective study. METHODS: The Corah's Dental Anxiety Scale (DAS), Children's Fear Survey Schedule Dental-Subscale (CFSS-DS) and Children's Fear Survey Schedule Short-Form (CFSS-SF) questionnaires were completed by parents of children undergoing dental treatment with oral midazolam. Behaviour was rated by a single clinician using the overall behaviour section of the Houpt-Scale and scores dichotomised into acceptable or unacceptable behaviour. Data were analysed using χ (2), t test and logistic regression analysis. RESULTS: In total 404 children (215 girls, 53 %) were included, with the mean age of 4.57 years, SD = 1.9. Behaviour was scored as acceptable in 336 (83 %) and unacceptable in 68 (17 %) children. STATISTICS: The level of a child's dental fear, as perceived by their parent, was significantly associated with the behaviour outcome (p = 0.001). Logistic regression analysis revealed that if the parentally perceived child's dental fear (CFSS-DS) rating was high, the odds of the child exhibiting unacceptable behaviour under oral sedation was two times greater than if their parents scored them a low dental fear rating (OR 2.27, 95 % CI 1.33-3.88, p = 0.003). CONCLUSIONS: CFSS-DS may be used preoperatively to help predict behaviour outcome when children are treated under oral sedation and facilitate treatment planning.