Non-traumatic dental presentations at accident and emergency departments in the UK: a systematic review.

Objective Attendance at accident and emergency departments (AE however, those that are take up capacity with conditions which are adding to the pressure regarding cost and healthcare utilisation for A&E departments. The scale of this problem is yet to be understood in the United Kingdom (UK). The aim of this study was to systematically review the literature to identify peer-reviewed research publications reporting non-traumatic dental presentations at A&E departments in the UK. Data sources A structured search of Cochrane Library, EMBASE, MEDLINE, CINAHL, PsycINFO, Scopus and Web of Science databases from their earliest date to May 2018. Hand-searching of identified articles that met the inclusion criteria was also reviewed. Data selection Publications were included if they were primary research on A&E users in the UK with NTDC as the primary reason for the A&E visit. Data extraction Data were extracted on the study, patient and visit characteristics. Data synthesis Studies were assessed for methodological quality and the analysis took the form of a narrative review. Conclusion There is limited evidence, of variable quality, to inform on the extent of inappropriate presentations of patients with non-urgent NTDC to A&E departments in the UK. The evidence supports the hypothesis that dental patients are inappropriately seeking care for NTDC at A&E departments and this may be a driver of unnecessary antibiotic prescriptions. Further research should focus on the reasons for this occurrence.