Dental triage and referrals for urgent care

April 2020 is a time we’ll all remember. It’s now over a month since dentists closed their doors. Although a necessary government decision, it has been hard for dentists to turn away patients from face-to-face treatment. (Why did that happen?) We understand the welfare of the whole population takes precedence over individual dental health. Yet we also understand our patients still have dental needs, even during the coronavirus lockdown. So we quickly set up remote access to dental triage and referrals for urgent dental care. Our aim is to continue to help you manage your dental problems.

Dental triage and referrals – how does it work?

Triage is the initial assessment of a patient who approaches us with a dental concern. Getting in touch is the starting point.

Please note: there is no charge for SpaDental’s triaging service.
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Over the last month, we’ve been receiving calls and emails from patients, as well as forms submitted from our website. We also welcome contact from people who aren’t registered patients too. As part of our normal services, we offer emergency care to non-registered holiday-makers and visitors to the area.

Anyone with a dental concern, whether it’s a simple question or a problem, may either:

• contact us by following the button in the green box above
• phone or email your nearest SpaDental practice

Recognising the need to ensure each individual case is recorded and followed up correctly, we’ve developed an efficient tracking procedure to manage your case from a distance, ensuring that you receive helpful advice at the professional level your condition requires.

As a group, the management team was already well set up for remote work. Now members of the clinical team are also working remotely to answer phones and offer patients advice.

What happens when I get in touch?

#1 Getting in touch

• If you’ve submitted an online form or sent an email, one of our team will soon be in touch.
• If you phoned, your call will go straight through to someone qualified to triage your condition.

#2 Your first contact

We have an experienced team on hand during regular working hours to answer your calls. If you call any of our practices out of hours, you’ll be directed to the NHS 111 emergency information service.

You’ll need to supply:

• Personal information for our records, such as date of birth, contact details, medications taken and general health.
• Information about your dental concern so the team can advise you.
• Additional information relating to COVID-19 exposure.

The clinician will take you through a series of questions. As far as patient assessment goes, establishing just how serious your condition is takes priority. That’s why you’ll be asked about bleeding or swelling.

Bleeding that won’t stop, and swelling that is increasing and threatens to block airways, is an emergency. The triage team will advise how to access care as soon as possible.

Even if you’re in a lot of pain it does not necessarily mean it’s urgent, but the team will help you to manage until you can have a planned appointment at a later date.

#3 Advice

The dental triage and referral team assess your case according to whether it’s non-urgent, urgent or an emergency.

•  Understanding the difference between routine, urgent and emergency care

While we would normally recommend a visit to a dentist or hygienist for non-urgent concerns patients ask us about, currently we offer help so you can manage the condition at home.

Our team will help you keep any problems under control with AAA until you can see a dentist face-to-face.

AAA is:

• • advice
  • analgesics
  • antimicrobials

#4 Referral to a SpaDental dentist

If you have a problem that requires a dentist’s assessment, such as a painful infection, or a possible referral to an Urgent Dental Care Centre for treatment, the team may organise a call with a dentist.

Please be patient if the dentist asks some of the same questions all over again. Confirmations are necessary. A conversation with a dentist is helpful in cases where antimicrobials will help manage your condition.

It is necessary to have a referral from a dentist to be seen at an Urgent Dental Care hub. However, following NHS guidelines, we can only refer urgent cases for face-to-face treatment, even though it may feel like an emergency to you.

#5 Visiting a UDC hub

Urgent Dental Care Centres have been set up around the country to see patients who need urgent or emergency dental care. Your referring dentist will try to get you into a nearby centre, if it’s necessary. Dental care is one of the few areas of NHS care patients pay a fee for. Unless you are exempt, NHS treatment charges will apply.

A summary of NHS urgent dental care pathways:

1. Emergency – Aim for immediate treatment on the same day. Patients are directed to an urgent dental care hub and/or hospital unit depending on severity. For example:
   • Oral, facial or dental infection with swelling / fever / airway risk.
   • Bleeding of dental origin that the patient cannot control.
   • Trauma of the facial skeleton.
   • Trauma to teeth needing management within a specific time frame (such as a knocked out tooth).
2. Urgent – Treatment recommended within 24 hours at a community dental facility. For example:
   • Oral dental conditions which are likely to exacerbate a systemic medical condition (such as diabetes).
   • Dental infection or localised swelling that would escalate without treatment.
   • Inflammation of gum tissue around unerupted (wisdom) tooth unresponsive to triage or AAA.
   • Dental infection that can be treated by removal of a tooth or the first stage of a root canal treatment.
   • Dental trauma of the teeth and/or supporting structures requiring outpatient facilities without a defined time-line for care.
3.  Non-urgent – Patients condition can be managed with triage and advice, analgesics or antimicrobials. Care can be managed by a planned appointment at a future time. For example:
   • Mild or moderate pain that is not associated with an urgent care condition and responds to over the counter medications
   • Minor dental trauma.
   • Post-extraction bleeding that the patient is able to control using self-help measures.
   • Loose or displaced crowns, bridges or veneers.
   • Fractured or loose-fitting dentures and other appliances including orthodontics.
   • Orthodontic problems causing trauma.
   • Fractured posts, loose or displaced fillings.
   • Treatments normally associated with routine dental care, such as bleeding gums.

People also ask:

Q. Can I take pain killers?

A. Ask a medical professional, such as your doctor, dentist or pharmacist, for advice about painkillers. Try to take only medications you have used without a problem in the past. Avoid anti-inflammatory medications such as ibuprofen if you may have been exposed to coronavirus or have asthma.

We hope our dental triage and referral service is helpful to you. We are continually working to improve and appreciate patient feedback.

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