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The financial and quality of life impact of urgent dental presentations: A cross-sectional study

Lookup NU author(s): David Edwards, Sabrina Rasaiah, Dr Matthew Breckons, Dr Simon StoneORCiD, Dr Charlotte CurrieORCiD, Professor Justin DurhamORCiD, Professor John Whitworth



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley-Blackwell Publishing Ltd, 2023.

For re-use rights please refer to the publisher's terms and conditions.


Aim: This study aimed to: (i) calculate personal financial costs associated with urgent dental attendance; and (ii) investigate the pain-related disability and quality of life impact of dental conditions which result in urgent dental attendance. Methodology: Data were collected from those presenting with urgent dental conditions to an out-of-hours dental service, a dental emergency clinic and five primary care general dental practices across North-East England. A pre-operative questionnaire explored the impact of urgent dental conditions on oral health-related quality of life (OHRQoL) using Oral Health Impact Profile-14 (OHIP-14) and modified Graded Chronic Pain Scale (GCPS). OHIP-14 yields a maximum score of 56, with a higher score indicating a lower OHRQoL. Personal financial costs were summed to provide a total. These included travel, appointment fees, childcare costs, medication use and time away from work. Data were analysed using one-way ANOVA and multivariable modelling. Results: In total, 714 participants were recruited. Mean OHIP-14 score was 25.73; 95% CI [24.67, 26.79], GCPS CPI was 71.69; 95% CI [70.09, 73.28] and GCPS interference was 49.56; 95% CI [47.24, 51.87]. Symptomatic irreversible pulpitis was the most frequently managed dental emergency and was associated with the highest mean OHIP-14 score (31.67; 95% CI [30.20, 33.15]). The mean personal financial cost of urgent dental care was £85.81; 95% CI [73.29, 98.33]. Differences in travel time (F[2, 691] = 10.24, p<.001), transport costs (F[2, 698] = 4.92, p=.004), and appointment time (F[2, 74] = 9.40, p<.001) were significant between patients attending an out-ofhours dental service, dental emergency clinic and dental practices for emergency care, with a dental emergency clinic being associated with the highest costs and dental practices the lowest. Conclusions: Diseases of the pulp and associated periapical disease were the most common reason for patients to present for urgent dental care and were the most impactful in terms of OHRQoL and pain in the present sample. Personal financial costs are significant from urgent dental conditions, with centralised services increasing the burden to patients of attending appointments. Funding: This study was funded by the European Society of Endodontology Young Investigator Research Grant (2020). Conflict of interest: The authors declare no conflict of interest.

Publication metadata

Author(s): Edwards D, Rasaiah S, Ahmed S, Breckons M, Stone SJ, Currie CC, Durham J, Whitworth J

Publication type: Article

Publication status: Published

Journal: International Endodontic Journal

Year: 2023

Volume: 56

Issue: 6

Pages: 697-709

Print publication date: 01/06/2023

Online publication date: 28/03/2023

Acceptance date: 24/03/2023

Date deposited: 30/03/2023

ISSN (print): 0143-2885

ISSN (electronic): 1365-2591

Publisher: Wiley-Blackwell Publishing Ltd


DOI: 10.1111/iej.13917

ePrints DOI: 10.57711/r5kh-x102

PubMed id: 36975836


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Funder referenceFunder name
European Society of Endodontology Young Researchers Grant (2020)