An investigation of transitional care pathways for young people following traumatic dental injuries

Br Dent J. 2021 Oct 6. doi: 10.1038/s41415-021-3471-4. Online ahead of print.

Abstract

Introduction Traumatic dental injuries (TDIs) can cause severe and complex dento-alveolar problems. Management of TDIs frequently extends into adulthood; therefore, a clear transitional care pathway (TCP) is important. Failure of this can prevent engagement in adult dental services and negatively influence treatment outcomes.Aims To assess the availability of TCPs from paediatric and adult specialist care for young people with TDIs.Materials and methods An anonymous, postal survey was designed and administered to all UK specialists in paediatric dentistry registered with the General Dental Council. Quantitative and qualitative data were gathered.Results The response rate was 58% (n = 130). Fifty-five percent (n = 72) stated that there was a dental trauma clinic for children within their locality, while only 22% (n = 29) stated that there was a dental trauma clinic for adults. Sixty-nine percent (n = 90) stated that there was no clear TCP within their locality and 41% (n = 37) of these highlighted a need for a TCP. Thematic analysis of opinions with regards to need for a TCP identified three main themes: pathway availability, access to resources and clinician experience. Following a course of treatment for a patient aged 12 years or above, 24% (n = 31) refer to specialist adult services, with 43% (n = 95) continuing to provide follow-up within paediatric dentistry.Conclusion Follow-up arrangements for young people with TDIs differ across the UK, with inconsistent availability of TCPs. Informal pathways involving referral to multidisciplinary teams may be utilised for follow-up care. Development of a TCP may aid in developing a consistent approach to long-term management of TDIs.