Characteristics and outcomes of medical emergencies in dentistry – an 8-year review of emergency calls at an Australian dental hospital

Aims: This study aimed to review Medical Emergency Team (MET) calls made at a public dental hospital to examine medical emergencies in dentistry and identify if any factors were associated with spontaneous recovery or urgent medical transfer. Methods: A retrospective review of MET call records from the Royal Dental Hospital of Melbourne was conducted over 8 years. Predictor variables were location, type of call, clinical context, and diagnosis. Outcome variables were spontaneous recovery or transfer to a tertiary medical hospital. Chi-square analyses were performed to determine if any predictor variables were associated with spontaneous recovery or medical transfer. Results: Among 156 MET calls, the General Dentistry Unit was the most frequent location (39.1%). Disability concerns were the most common reason for calls (39.1%), with vasovagal syncope being the most common diagnosis (33.3%). Calls were most frequently made for patients prior to receiving dental treatment (26.3%). Most patients (64.7%) recovered spontaneously, while 25.6% required urgent medical transfer. Calls related to circulatory issues or patients diagnosed with a cardiovascular condition were more likely to require medical transfer (p<0.05). Calls made for concerns regarding disability, for patients awaiting treatment, and for patients with a psychological diagnosis were associated with increased chance of spontaneous recovery (p<0.05). Conclusion: Emergency calls at a dental hospital are most likely to be triggered by concerns regarding disability prior to commencement of dental treatment, with vasovagal syncope being the most common diagnosis. Concerns regarding circulation or patients with a provisional cardiovascular diagnosis are more likely to require medical transfer.