Odontogenic infections: a national survey to assess confidence of the OMFS “first on-call”

Odontogenic infections can range from simple toothache to life-threatening swellings in the neck. We conducted a national survey to assess the confidence of the “first on-call” in oral and maxillofacial surgery (OMFS) to admit or discharge these patients, and to see if local protocols or guidelines were in place to aid decision-making. We designed a questionnaire and emailed it to all OMFS units across the UK over a 3-week period in June 2015. We also contacted first on-call OMFS juniors by phone. A total of 54 respondents were confident and 24 were very confident to admit patients with odontogenic infections without a senior review, but only 45 were confident and 9 very confident to discharge patients from the emergency department without a senior review. Twenty-one were fairly confident to admit patients, and 37 were fairly confident to discharge them. One respondent was not confident to admit patients at all, and 9 did not feel confident to discharge patients without a senior review. Seventy-eight reported that no local protocols or structured guidance on odontogenic infections were used in their unit. This survey highlights the need for admission criteria to help junior clinicians decide whether to admit or discharge these patients.