Paramedic Exposure and Response to Non-Traumatic Dental Conditions

Abstract

Introduction As the global demand for emergency health services continues to expand, the role of paramedics persists and grows alongside the expansion of ambulance services. The need to explore alternative pathways for enhancing service efficiency and alleviating hospital demands is increasingly evident, particularly for low-acuity cases.  Non-traumatic dental conditions (NTDC) can be ongoing and have far-reaching health implications if not treated correctly. This scoping review aims to explore what is known about the incidence of NTDC cases attended by paramedics internationally. Methods Three electronic databases (Medline, Scopus, CINAHL) were searched between 1 Jan 2000 and 30 April 2023, using the primary search terms “paramedics,” “prehospital,” and “dental emergency.”  In addition, grey literature was examined using Google Scholar. Studies were included if they investigated NTDC as the primary treatment condition in the prehospital setting (excluding clinical settings) and were written in English. Results Of 1755 articles identified only four studies met the inclusion criteria. Three were quantitative descriptive surveys, and one study included interview data. Studies originated in Poland, the United States, Turkey, and India. Paramedics who reported attending an NTDC case varied between 28% and 72%. Two papers reported on the demographics of patients most affected by NTDC, including young children aged 7-15 and older individuals between the ages of 45-64. Despite limitations and bias across all studies, results indicated insufficient knowledge and education of paramedics regarding dental anatomy or proper management of NTDC. Conclusion This scoping review identified a paucity of robust research and publications investigating the paramedic role in initial treatment and referral pathways of dental injuries. There was limited information on the paramedic’s knowledge, attitude, and training in dental injuries. Further research is required to determine paramedics’ preparedness to manage and improve patient outcomes to reduce the growing burden on emergency departments.