Emergency dentistry in the integrated healthcare system: experiences form the emergency dental service in the city of Zagreb

Abstract

Introduction Emergency dental services are an important establishment for accessing immediate care for patients with acute odontogenic conditions, some of which are potentially life-threatening. The city of Zagreb has been providing this type of service free of charge for the past 15 years to its citizens and the citizens of Zagreb’s county. In the past years, there has been a graduate increase of patients attending our clinics, specifically, an average of 20329 patients has attended every year for the past three years. This type of service is unique in the sense that it is accessible to anyone during workday nights (from 10 pm to 6 am), weekends and public holidays (24/7). Description of policy context and objective As an objective, this service has the intention to provide urgent care for patients experiencing a dental emergency in situations when patients have no access to their family dentist. This gives our City’s citizens a sense of confidence and safety in the integrated healthcare system and is often the last resort for patients who for any reason have obstacles in receiving dental care. The obstacles vary from incompatible working hours, low income to lack of confidence in treatment or dental fear and anxiety. This kind of medical service is important for an integrated healthcare system since dental services are often fragmented and have long waiting lists. Patients, therefore, can find themselves in an uneasy situation if an emergency occurs. Targeted population The city of Zagreb and its metropolitan area has 1,088,841 citizens. A substantial influx of citizens of other counties seeking work and living within the city has contributed to its growth, which is only expected to continue into the future. The service is provided through three dental offices positioned in the west, east and center/south part of the city, to make access to service easier and a total of seven dental teams are employed. Highlights Due to the high numbers of patients frequenting our service we can say that there is an obvious need for emergency dentistry and our service is often the only resort for patients with acute dental conditions. In the year 2018 alone, there was a total of 22,201 patients who visited and had 59.858 procedures done. Financing comes mostly from the local municipality (The city of Zagreb) and part from the Croatian Health Insurance Fund. By providing emergency care the risk of serious and possibly life-threatening complications which require expensive hospitalization is decreased since most emergency procedures can be done with smaller patient discomfort. Comments on transferability This service design can be transferred to other municipalities who aim to decrease the seriousness and severity of dental emergencies and the costs that they can cause. This would be useful for areas with a shortage of dentists and specialists in various fields of dentistry, which is often seen in rural areas. Conclusions Emergency dentistry should be accessible to anyone in an integrated system considering the various obstacles for receiving dental care, and shouldn’t rely on hospital admissions.