Jingjing Yu, DDS1, Tian Zhang2, Dan Zhao, DDS, PhD1,3, Markus Haapasalo, DDS, PhD2, Ya Shen, DDS, PhD2
1The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; 2Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada; 3General and Emergency Department, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Journal of Endodontics 46(6): in press, June 2020
Acknowledgement: The authors deny any conflicts of interest. This work was partly supported by grants from the National Natural Science Foundation of China (grant no. 81901000).
Dr. Dan Zhao
State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education
School and Hospital of Stomatology
237 Luoyu Road
Wuhan 430079, P.R. China.
Introduction: In late 2019 an outbreak of a new coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in Wuhan, China. A great percentage of patients with this disease developed symptoms of dry cough, malaise and high fever. During this time several patients requiring assessment and treatment of endodontic emergencies were directed to the School and Hospital of Stomatology at Wuhan University (WHUSS). Here, we examined the characteristics of these patients. Methods: A total of 96 patients with mean age of 42.24 ± 18.32 years visited General and Emergency Department of WHUSS due to endodontic emergencies during the peak period of February 22 to March 2, 2020. Patient information was collected and organized by date of visit, gender, age, systemic diseases history. Body temperature was measured and acquired for each patient, a coronavirus disease 2019 (COVID-19) epidemiological investigation questionnaire was given to each patient, endodontic diagnosis determined for the offending tooth and verbal numerical rating scale (VNRS) was used to record pain levels. Results: Of total patient visits during this period, 50.26% of visits were for endodontic treatment. No patients had fever (>37.2℃). One patient with a confirmed COVID-19 history was admitted after recovery. Three admitted patients had been exposed to confirmed or suspected COVID-19 patients. Twelve admitted patients (12.5%) with mean age of 62.42 ± 13.77 years had a history of systemic diseases. The most common age group for endodontic emergencies was 45-64 years (30.21%) and patients of this group showed significantly higher mean VNRS score compared with that of the 6-19 years group and 20-34 years group (p<0.05). The majority of endodontic emergency diagnosis was diseases of symptomatic irreversible pulpitis (53.10%). Patients who were diagnosed with symptomatic irreversible pulpitis, symptomatic apical periodontitis and acute apical abscess showed significantly higher mean VNRS Score than that of other groups (p<0.05). Conclusion: Endodontic emergencies, with symptomatic irreversible pulpitis being the most common, consist of a much higher proportion of dental emergencies in a COVID-19 high risk area than normally. Vital pulp therapy can advantageously reduce treatment time resulting in reduced risk of infection for vital pulp cases. Rubber dam, personal protective equipment and patient screening are of great importance during the COVID-19 outbreak in protecting clinicians.