50

Objective : This study was designed to develop and evaluate a guidance tool to refer patients with dental emergencies to a hospital dental emergency unit.Methods : The referring tool was first developed. It was designed to define a waiting time for patient management by assessing the clinical signs described by these patients on presentation at the dental care unit. The validity of the tool was then assessed by comparing the waiting time defined by the referring tool to that defined by a practitioner for 300 patients attending the Emergency Dental Unit in Clermont-Ferrand. Indicators for specificity, sensitivity and the kappa coefficient were used.Results : The referring tool was able to define a waiting time for 92% of patients. It was able to correctly identify patients needing care “within 24h” (s = 0.84, k = 0.72). Patients who reported few symptoms were referred within a “3-7 days” waiting time (s = 0.88, k = 0.62). The tool was less effective for patients needing care within “1-2 days” (s = 0.42, k = 0.41), whose clinical signs were less acute. Specificity exceeded 0.8 in every case. Accordingly, regardless of the waiting time, the use of this tool avoided scheduling appointments for patients who did not need care. The tool facilitated emergency unit activity, as 50% of the appointments could be scheduled beyond 24 hours.Conclusion : The metrological characteristics of the referring tool were well adapted to the setting studied.