April 26, 2022

FYI Series: Understating Symptoms and the 3 stages of Dental Triage

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Anthony Krystopher
April 26, 2022

FYI Series: Understating Symptoms and the 3 stages of Dental Triage

Anthony Krystopher

Over the course of the pandemic, you might have encountered a variety of blocks to accessing care, wondering "why can't I get an appointment?" with unexplained delays and cancellations, as practices have struggled with nurse shortages, dentist shortages, changes to operating procedures and appointment durations, covid security measures, sickness and quarantine, as well as shuffling patients around to prioritise the high priority cases from the low, whilst still trying to accommodate everyone with less help, less time and less resources. Whilst most restrictions have lifted, many issues causes by the pandemic yet remain.


Our Smart Dental Care practices try their best to balance the issues and prioritise the urgent cases to be seen at the earliest possibility, and we hope that you’ve managed to stay on top of your dental health throughout these uncertain times.


But what constitutes low priority and high priority? Even a small amount of toothache can be crippling to some and affect the whole day.

With many dental surgeries having to prioritise urgent and essential treatment, the aim of this post is to help you understand their triage process and to make sure you’ve done all you can do to ensure a smooth process, by communicating your situation clearly to the practice at the first point of contact.


The Three Categories of Dental Care

Emergency


Patients in need of emergency level care must try to see a clinician within the hour, whether that be at the dentist, an emergency care facility, or the emergency room at a hospital. These situations are usually brought on by traumatic injury like sporting injuries or violence, but some emergencies can occur after dental surgery, such as tooth extractions.


Identify an emergency need -


  • Extreme, debilitating pain
  • Heavy bleeding that isn’t stopping, such as from a tooth removal
  • Significant facial swelling which is getting worse
  • Traumatic injuries after accidents, such as a broken or dislocated jaw
  • Lodged foreign body in the gum or mouth area, such as a large bone from food causing bleeding or inhibiting normal function
  • Severe infection which has spread to other nearby areas such as the ear, sinus, throat and jaw
  • Inability to move your jaw, which could be trismus brought on by inflammation or a possible side effect of tooth extraction (lockjaw)


Okay, what now?


Emergency dental practices have the facilities to provide appropriate care for problems such as a knocked out tooth, infections, swelling or bleeding after a removal, and will direct you to the hospital if necessary.


Whoever you end up in contact with, whether it’s on the phone or in person, do your best to clearly express your symptoms and pain levels so they can direct you quickly and appropriately - visiting a dentist with a broken jaw wouldn’t be recommended and you’d be better off getting to a hospital as soon as possible.


  • Do not underestimate or shrug off worrying symptoms. Dental emergencies can sometimes have life threatening consequences and poor explanations can lead to delays, missed diagnosis or cause a referral to an emergency dentist when you might need a hospital
  • Likewise, exaggerating your symptoms can cause problems or even loss of life for other people with more immediate needs
  • Make a note about your ailments from the onset to help organise your thoughts. Use keywords and phrases to accurately describe your circumstances
  • If you’re not able to communicate, either have a friend or family member vouch for you.


If you believe the condition could be life-threatening, call the emergency services, or use the NHS 111 service (online or over the phone) for advice and instruction on what to do next.


Urgent


For urgent matters, patients do have some time to get some help with a condition, ideally getting treatment within 24 hours from the onset of the problem.


Identify an urgent need -


  • Moderate to severe pain which cannot be managed effectively with medications prescribed by the dentist or non-prescription painkillers
  • Broken teeth with exposed pulp
  • Moderate infections which haven’t started to affect surrounding areas like the ears, sinuses, jaw or throat
  • Tell-tale signs of progressing dental abscesses if there is a history


Okay, what now?


Dentists will give priority to patients which need urgent care, rearranging routine checkups, hygiene and cosmetic appointments to fit a patient in if required. Your choice of wording is especially important here: as mentioned earlier, do not downplay your symptoms or pass off excruciating pain as ‘it’s pretty bad I guess’ or simply ‘it hurts’.

Vocabulary and phrases are crucial, as well as using a numerical value such as “If toothache is a 4/10, this is a 7/10.”

These are great identifiers for staff, not just at your practice but at GP surgeries and hospitals too, and allows you to be treated accordingly with an urgency appropriate for the situation.


Routine


Routine matters are problems which pose no immediate danger to the patient like an emergency does, and no escalating concerns like with urgent matters. Any pain is manageable, blood loss is minimal or not present, no injuries, worsening swelling or identified complications. This makes routine cases more flexible.


Identify a routine need -


Just because there are no immediate dangers, this does not mean delay and avoid until the problem snowballs into an emergency - it means you should book an appointment at the earliest convenience if you’re experiencing any of the following symptoms;


  • Mild to moderate pain which responds to pain-killers and prescribed medications
  • Bleeding after a tooth extraction, which stops when you follow dentist instruction
  • Loose or displaced crowns, bridges or veneers
  • Broken or loose dentures or bridges
  • Bleeding gums
  • Other bleeding or swelling which is under control, either staying the same or subsiding
  • Loose or missing fillings


Okay, what now?


Now more than ever, your practice may need you to do a bit more to manage the condition yourself and cope until they can fit you in for an appointment. Here are some ways to manage symptoms of routine cases;


  • Swill with Salt water regularly
  • Corsodyl for gum problems, like bleeding, minor injuries or early signs of disease
  • Painkillers like ibuprofen for swelling and paracetamol for infection induced fever
  • Orajel and other numbing agents to alleviate localised pain and allow you to give yourself a break from painkillers. If you're unfamiliar, Orajel doesn't require a prescription and is available in most supermarkets and pharmacies
  • Ice packs to settle sensitive, swollen or tender areas
  • Avoid things that are very hot, cold, sweet or spicy as these can aggravate dental pain
  • Sleep with your head elevated to avoid a rush of blood making sensitive areas in the mouth feel even worse, and reduce night time hassle


Aside from these tips, which are broadly recommended across dental and other medical professionals, be wary of other therapies or ‘at home’ guides you may see online, some techniques may end up having serious consequences for your dental health.


If you’re experiencing an urgent or routine need as mentioned above, feel free to book an appointment online or call us on 0161 820 3477.


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