A retrospective investigation of the clinical management of patients attending an out of hours dental clinic in Merseyside under the new NHS dental contract

Key Points Details the importance of appropriate management of patients attending emergency out of hours clinics. Highlights the continued inappropriate use of antibiotics for treating certain conditions. Demonstrates that there exists a poor understanding of clinical and best practice guidelines among some clinicians with respect to the examination and management of emergency patients. Aim To investigate the clinical management of patients attending for emergency dental treatment. Design A retrospective analysis of clinical record cards. Method Information was collected from patient record cards concerning the patient's reason for attendance and their management at an emergency dental clinic in South Sefton, Liverpool. Results Over a nine month period, 1,718 patients attended the clinic; 1,472 record cards were analysed. Over 80% of the patients attending the out of hours (OOH) clinic had pain associated with a localised dental infection or dental abscess. Where a diagnosis was recorded, only 67% of patients received appropriate treatment. Over 50% of patients received antibiotics alone with no other definitive treatment provided. The principal antibiotic prescribed for both adult and child patients was amoxicillin. Conclusion The current study has highlighted that GDPs working within the OOH services are not adhering to current clinical and best practice guidelines with respect to patient examination, diagnosis, management, in particular the correct prescribing of antibiotics for dental infections, and clinical record keeping.