Timescales for treatment
Timescales for treatment
This guidance builds on the Scottish Dental Clinical Effectiveness Programme’s Emergency Dental Care guidance which included recommended timescales for access to treatment services for different categories of dental need.9 Based on these timescales, the categories presented below are used throughout this guidance to indicate the likely urgency of clinical need for each oral condition. The degree of urgency within each category might be further informed by clinical judgement in individual cases.
The times stated are intended to indicate recommended best practice to guide an appropriate response according to clinical need, and every effort should be made to provide care within the recommended timescales. However, it is acknowledged that this may not be feasible in all cases and some allowance on treatment times might be required, taking into account, for example, remoteness, patient travel and variation in providers of care in different locations. Where a patient cannot be seen within the recommended timescale, care should be provided as soon as practicably possible.
Categories of care
Emergency Care - Medical
If the dental problem is resulting in severe or life-threatening symptoms (e.g. severe dehydration, signs of airway compromise or sepsis) or is secondary to a more significant problem (e.g. a significant facial injury) advise or arrange immediate contact with appropriate medical services via NHS24/NHS111 (Tel: 111) or by calling 999.
Emergency Care - Dental
Arrange for the patient to have immediate contact with a dental advisor, ideally within 60 minutes, and subsequent treatment within a timescale that is appropriate to the severity of the condition.
Urgent Care
Advise the patient to seek urgent dental or medical care at the next available clinic, within 24 hours or as soon as practicable, unless the condition worsens. Treatment should not be delayed if the patient can be seen sooner than 24 hours.
Non-urgent Care
Advise the patient to see a dentist within 7 days if required unless the condition worsens.
Self Care
The patient should be able to manage the problem without the need for further involvement of a healthcare professional. However, advise the patient that if the symptoms persist or worsen, they should contact a dentist or general medical practitioner.
Providers of care
The timescale categories should apply at any time in the 24 hour period. When there is a preferred provider of care, this is indicated in the guidance. Providers of care may vary depending on location.
During normal working hours, all dental practices in Scotland have arrangements to provide emergency care for their registered patients. Health boards also have local emergency dental arrangements in place for non-registered patients. Helpline phone numbers for emergency dental services in Scotland are available via local health board websites or NHS Inform. Advice on accessing urgent or emergency dental care in the rest of the UK is available via the NHS UK, NHS111 Wales or Health and Social Care Northern Ireland websites.
In the out-of-hours period (typically 18.00 to 08.00 hours during the week and throughout the weekend), some dental practices in Scotland have their own emergency arrangements. In addition, a full triage and patient booking service is available through NHS24 (Tel: 111). In England and Wales patients should contact NHS111online (Tel: 111) or NHS111Wales (Tel: 111). Out-of-hours emergency dental care may also be available within the private sector.
Emergency medical care might be provided in an emergency department, urgent care centre or community hospital depending on the clinical need and location.