Medical emergencies during exodontia in a referral dental center in Saudi Arabia: A cross-sectional study

Abstract

Background: Medical emergencies such as vasovagal attack, hypoglycemia, and asthmatic attacks that are not related to dentoalveolar procedures, such as bleeding and airway obstruction, etc., do occur in dental clinics; among these emergencies, about 90% are mild, while 8% are severe. Objectives: In this study, the prevalence and management of medical emergencies that occurred during simple and complex exodontia were reported. Methods: Herein, a 2-year prospective cross-sectional study was conducted on patients who were referred to an oral and maxillofacial surgery clinic for dental extractions between January 2019 and December 2020. Patient data including socio-demographic information, pre-existing medical conditions, modality of tooth extraction, types of emergencies encountered, and management protocols were collected. Results: Of 3706 patients, 105 patients had medical emergencies with a prevalence rate of 2.8%. In all, 44 (41.9%) male and 61 (58.1%) female patients aged between 18 and 69 years with a mean (±SD) of 36.9 (11.7) were identified. The reported medical emergencies included vasovagal syncope (38 (36.1%)), hypoglycemia (27 (25.7%)), orthostatic hypotension (26 (24.8%)), asthmatic attacks (5 (4.8%)), hyperventilation syndrome (5 (4.8%)), and seizures (4 (3.8%)). The reported pre-existing medical conditions in these patients included Type II diabetes (DM) + hypertension (HTN) + coronary artery surgery (CAS) (4 (3.8%)), asthma (5 (4.8%)), and seizure disorders (4 (3.8%)). The majority of patients did not exhibit any medical conditions (92 (87.6%)), and most of them recovered spontaneously (47 (44.7%) patients). Conclusion: The majority of patients did not have medical conditions. Vasovagal syncope was the most common medical emergency, followed by hypoglycemia. Asthmatic attacks, hyperventilation syndrome, and seizures were the least reported medical emergencies. Cardiac emergency cases were not reported.