ORIGINAL ARTICLE

Same-day emergencies in endodontic specialists' practice: Before, during and after the COVID-19 pandemic

Corresponding Author

Ali Nosrat

[email protected]

orcid.org/0000-0003-4768-9717

Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland, USA

Private Practice, Centreville Endodontics, Centreville, Virginia, USA

Correspondence

Ali Nosrat, Division of Endodontics, School of Dentistry, University of Maryland in Baltimore, 650 West Baltimore Street, Baltimore, MD 21201, USA.

Email: [email protected]

Search for more papers by this author

Yuke Tian,

Yuke Tian

orcid.org/0009-0008-3626-8574

Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, USA

Search for more papers by this author

Prashant Verma,

Prashant Verma

orcid.org/0000-0002-5430-2245

Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland, USA

Private Practice, Centreville Endodontics, Centreville, Virginia, USA

Private Practice, Capitol Endodontics, Washington, DC, USA

Search for more papers by this author

Nardin Mossad,

Nardin Mossad

orcid.org/0009-0004-4039-1795

School of Dentistry, Meharry Medical College, Nashville, Tennessee, USA

Search for more papers by this author

Di Wu,

Di Wu

orcid.org/0000-0001-8331-2357

Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, USA

Division of Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA

Search for more papers by this author

Ashraf F. Fouad,

Ashraf F. Fouad

orcid.org/0000-0001-6368-1665

Department of Endodontics, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama, USA

Search for more papers by this author

Ali Nosrat,

Corresponding Author

Ali Nosrat

[email protected]

orcid.org/0000-0003-4768-9717

Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland, USA

Private Practice, Centreville Endodontics, Centreville, Virginia, USA

Correspondence

Ali Nosrat, Division of Endodontics, School of Dentistry, University of Maryland in Baltimore, 650 West Baltimore Street, Baltimore, MD 21201, USA.

Email: [email protected]

Search for more papers by this author

Yuke Tian,

Yuke Tian

orcid.org/0009-0008-3626-8574

Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, USA

Search for more papers by this author

Prashant Verma,

Prashant Verma

orcid.org/0000-0002-5430-2245

Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland Baltimore, Baltimore, Maryland, USA

Private Practice, Centreville Endodontics, Centreville, Virginia, USA

Private Practice, Capitol Endodontics, Washington, DC, USA

Search for more papers by this author

Nardin Mossad,

Nardin Mossad

orcid.org/0009-0004-4039-1795

School of Dentistry, Meharry Medical College, Nashville, Tennessee, USA

Search for more papers by this author

Di Wu,

Di Wu

orcid.org/0000-0001-8331-2357

Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, USA

Division of Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA

Search for more papers by this author

Ashraf F. Fouad,

Ashraf F. Fouad

orcid.org/0000-0001-6368-1665

Department of Endodontics, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama, USA

Search for more papers by this author

First published: 20 March 2025

https://doi.org/10.1111/iej.14228

Share a link

Email
Wechat
Bluesky

Abstract

Aim

The COVID-19 pandemic affected practice in endodontic offices. Same-day endodontic emergencies are cases with moderate or severe self-reported pain who request an unscheduled visit on the day they contact the office. The aims of this observational study were to: (A) analyse the rate of same-day endodontic emergencies in two endodontists' private offices, with respect to their demographic, aetiologic, diagnostic and procedural data; and (B) investigate the changes in characteristics of same-day emergencies between March 16 and May 31 annually over five years: 2019–2023.

Methodology

Records of 5795 patients were reviewed and 892 same-day emergencies were identified. Overall and year-to-year comparisons of proportions of same-day emergencies, as well as demographic, aetiologic, diagnostic and procedural data were performed using chi-square test of independence followed by adjustments for multiple testing using the Benjamini-Hochberg method.

Results

The rate of same-day endodontic emergencies significantly increased during the initial outbreak of COVID-19 in 2020 and remained high in 2021 (p < .05; Q < .05). The rate of same-day emergencies in 2022 subsided to levels comparable to 2019 (p > .05). Year-to-year comparisons of aetiologic factors (caries, restorative, persistent infection and cracks) showed a significant increase only in the rate of cracks in 2020, 2021and 2022 compared with 2019 (p < .05), but this increase did not reach the significance level after adjusting for multiple comparisons throughout the 5 years (Q > .05).

Conclusions

The COVID-19 pandemic was associated with a significant increase in the rate of same-day endodontic emergencies for 2 years. The spike in endodontic emergencies associated with the COVID-19 pandemic lasted well beyond the initial period of the outbreak. Further national and international studies are recommended to better understand the long-term impacts of pandemics of respiratory diseases on the public's oral health.

CONFLICT OF INTEREST STATEMENT

The authors confirm they have no conflict of interest.

Open Research

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

REFERENCES

Alaçam, T. & Tinaz, A.C. (2002) Interappointment emergencies in teeth with necrotic pulps. Journal of Endodontics, 28, 375–377.
10.1097/00004770-200205000-00007
PubMed Web of Science® Google Scholar
American Dental Association, Health Policy Institute. (2021) COVID-19: Economic Impact on Dental Practices Week of October 11 QOW Results [Online]. Available at: https://surveys.ada.org/reports/RC/public/YWRhc3VydmV5cy02MTY4OGNkZjRkMGNmZTAwMTc0Y2MzOTQtVVJfM3BaeGhzWm12TnNMdjB4 [Accessed 3rd December 2022].
Google Scholar
Azim, A.A., Azim, K.A. & Abbott, P.V. (2017) Prevalence of inter-appointment endodontic flare-ups and host-related factors. Clinical Oral Investigations, 21, 889–894.
10.1007/s00784-016-1839-7
PubMed Web of Science® Google Scholar
Barrett, B., McGovern, J., Catanzaro, W., Coble, S., Redden, D. & Fouad, A.F. (2022) Clinical efficacy of an Extraoral dental evacuation device in aerosol elimination during endodontic access preparation. Journal of Endodontia, 48, 1468–1475.
10.1016/j.joen.2022.09.007
PubMed Web of Science® Google Scholar
Cagetti, M.G., Balian, A., Camoni, N. & Campus, G. (2021) Influence of the COVID-19 pandemic on dental emergency admissions in an urgent dental Care Service in North Italy. International Journal of Environmental Research and Public Health, 18(4), 1812. Available from: https://doi.org/10.3390/ijerph18041812
10.3390/ijerph18041812
PubMed Web of Science® Google Scholar
Carrillo-Diaz, M., Ortega-Martínez, A.R., Romero-Maroto, M. & González-Olmo, M.J. (2022) Lockdown impact on lifestyle and its association with oral parafunctional habits and bruxism in a Spanish adolescent population. International Journal of Paediatric Dentistry, 32, 185–193.
10.1111/ipd.12843
PubMed Web of Science® Google Scholar
CDC Museum. (2024) COVID-19 Timeline [Online]. United States. Available at: https://www.cdc.gov/museum/timeline/covid19.html [Accessed 12th October 2024].
Google Scholar
Di Giacomo, P., Serritella, E., Imondi, F. & Di Paolo, C. (2021) Psychological impact of COVID-19 pandemic on TMD subjects. European Review for Medical and Pharmacological Sciences, 25, 4616–4626.
CAS PubMed Web of Science® Google Scholar
Estrela, C., Decurcio Dde, A., Silva, J.A., Batista, A.C., De Souza Lima, N.C., De Freitas Silva, B.S. et al. (2016) Immune-inflammatory cell profile and receptor activator of nuclear factor kappa B ligand/osteoprotegerin expression in persistent apical periodontitis after root canal retreatment failure. Journal of Endodontia, 42, 439–446.
10.1016/j.joen.2015.11.012
PubMed Web of Science® Google Scholar
Gasteiger, N., Vedhara, K., Massey, A., Jia, R., Ayling, K., Chalder, T. et al. (2021) Depression, anxiety and stress during the COVID-19 pandemic: results from a New Zealand cohort study on mental well-being. BMJ Open, 11, e045325.
10.1136/bmjopen-2020-045325
PubMed Web of Science® Google Scholar
Guan, H., Nuth, M., Weiss, S.R., Fausto, A., Liu, Y., Koo, H. et al. (2023) HOCl rapidly kills Corona, flu, and herpes to prevent aerosol spread. Journal of Dental Research, 102, 1031–1037.
10.1177/00220345231169434
CAS PubMed Web of Science® Google Scholar
Hatipoğlu, Ö., Martins, J.F.B., Karobari, M.I., Taha, N., Aldhelai, T.A., Ayyad, D.M. et al. (2024) Repair versus replacement of defective direct dental restorations: a multinational cross-sectional study with meta-analysis. Journal of Dentistry, 148, 105096.
10.1016/j.jdent.2024.105096
PubMed Web of Science® Google Scholar
Iqbal, M., Kim, S. & Yoon, F. (2007) An investigation into differential diagnosis of pulp and periapical pain: a PennEndo database study. Journal of Endodontia, 33, 548–551.
10.1016/j.joen.2007.01.006
PubMed Web of Science® Google Scholar
Jahrami, H.A., Alhaj, O.A., Humood, A.M., Alenezi, A.F., Fekih-Romdhane, F., Alrasheed, M.M. et al. (2022) Sleep disturbances during the COVID-19 pandemic: a systematic review, meta-analysis, and meta-regression. Sleep Medicine Reviews, 62, 101591.
10.1016/j.smrv.2022.101591
CAS PubMed Web of Science® Google Scholar
Kranz, A.M., Chen, A., Gahlon, G. & Stein, B.D. (2021) 2020 trends in dental office visits during the COVID-19 pandemic. Journal of the American Dental Association, 152, 535–541.e1.
10.1016/j.adaj.2021.02.016
PubMed Web of Science® Google Scholar
Langella, J., Magnuson, B., Finkelman, M.D. & Amato, R. (2021) Clinical response to COVID-19 and utilization of an Emergency Dental Clinic in an Academic Institution. Journal of Endodontics, 47, 566–571.
10.1016/j.joen.2020.11.025
PubMed Google Scholar
Law, A.S., Nixdorf, D.R., Aguirre, A.M., Reams, G.J., Tortomasi, A.J., Manne, B.D. et al. (2015) Predicting severe pain after root canal therapy in the National Dental PBRN. Journal of Dental Research, 94, 37S–43S.
10.1177/0022034514555144
CAS PubMed Web of Science® Google Scholar
Lehmann, A., Nijakowski, K., Jankowski, J., Donnermeyer, D., Palma, P.J., Drobac, M. et al. (2024) Awareness of possible complications associated with direct composite restorations: a multinational survey among dentists from 13 countries with meta-analysis. Journal of Dentistry, 145, 105009.
10.1016/j.jdent.2024.105009
PubMed Web of Science® Google Scholar
Matsuyama, Y., Aida, J., Takeuchi, K., Koyama, S. & Tabuchi, T. (2021) Dental pain and worsened socioeconomic conditions due to the COVID-19 pandemic. Journal of Dental Research, 100, 591–598.
10.1177/00220345211005782
CAS PubMed Web of Science® Google Scholar
Nalliah, R.P., Allareddy, V., Elangovan, S., Karimbux, N., Lee, M.K., Gajendrareddy, P. et al. (2011) Hospital emergency department visits attributed to pulpal and periapical disease in the United States in 2006. Journal of Endodontia, 37, 6–9.
10.1016/j.joen.2010.09.006
PubMed Web of Science® Google Scholar
Nixdorf, D.R., Law, A.S., John, M.T., Sobieh, R.M., Kohli, R. & Nguyen, R.H. (2015) Differential diagnoses for persistent pain after root canal treatment: a study in the National Dental Practice-based Research Network. Journal of Endodontics, 41, 457–463.
10.1016/j.joen.2014.12.012
PubMed Web of Science® Google Scholar
Nixdorf, D.R., Law, A.S., Lindquist, K., Reams, G.J., Cole, E., Kanter, K. et al. (2016) Frequency, impact, and predictors of persistent pain after root canal treatment: a national dental PBRN study. Pain, 157, 159–165.
10.1097/j.pain.0000000000000343
PubMed Web of Science® Google Scholar
Nosrat, A., Dianat, O., Verma, P., Nixdorf, D.R. & Law, A.S. (2021) Postoperative pain: an analysis on evolution of research in half-century. Journal of Endodontics, 47, 358–365.
10.1016/j.joen.2020.11.021
PubMed Web of Science® Google Scholar
Nosrat, A., Dianat, O., Verma, P., Yu, P., Wu, D. & Fouad, A.F. (2022) Endodontics specialists' practice during the initial outbreak of coronavirus disease 2019. Journal of Endodontics, 48, 102–108.
10.1016/j.joen.2021.09.015
PubMed Web of Science® Google Scholar
Nosrat, A., Valancius, M., Mehrzad, S., Dianat, O., Verma, P., Aminoshariae, A. et al. (2023) Flare-ups after nonsurgical retreatments: incidence, associated factors, and prediction. Journal of Endodontics, 49, 1299–1307.e1.
10.1016/j.joen.2023.07.004
PubMed Web of Science® Google Scholar
Nosrat, A., Yu, P., Dianat, O., Verma, P., Taheri, S., Wu, D. et al. (2022) Endodontic Specialists' practice during the coronavirus disease 2019 pandemic: 1 year after the initial outbreak. Journal of Endodontics, 48, 699–706.
10.1016/j.joen.2022.03.004
PubMed Web of Science® Google Scholar
Nosrat, A., Yu, P., Verma, P., Dianat, O., Wu, D. & Fouad, A.F. (2022) Was the coronavirus disease 2019 pandemic associated with an increased rate of cracked teeth? Journal of Endodontics, 48, 1241–1247.
10.1016/j.joen.2022.07.002
PubMed Web of Science® Google Scholar
Pickenpaugh, L., Reader, A., Beck, M., Meyers, W.J. & Peterson, L.J. (2001) Effect of prophylactic amoxicillin on endodontic flare-up in asymptomatic, necrotic teeth. Journal of Endodontics, 27, 53–56.
10.1097/00004770-200101000-00019
CAS PubMed Web of Science® Google Scholar
Quiñonez, C., Gibson, D., Jokovic, A. & Locker, D. (2009) Emergency department visits for dental care of nontraumatic origin. Community Dentistry and Oral Epidemiology, 37, 366–371.
10.1111/j.1600-0528.2009.00476.x
PubMed Web of Science® Google Scholar
Saumya-Rajesh, P., Krithikadatta, J., Velmurugan, N. & Sooriaprakas, C. (2017) Post-instrumentation pain after the use of either Mtwo or the SAF system: a randomized controlled clinical trial. International Endodontic Journal, 50, 750–760.
10.1111/iej.12702
CAS PubMed Web of Science® Google Scholar
Von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., Gøtzsche, P.C. & Van den Broucke, J.P. (2014) The Strengthening the reporting of observational studies in epidemiology (STROBE) Statement: guidelines for reporting observational studies. International Journal of Surgery, 12, 1495–1499.
10.1016/j.ijsu.2014.07.013
PubMed Web of Science® Google Scholar
Walton, R. & Fouad, A. (1992) Endodontic interappointment flare-ups: a prospective study of incidence and related factors. Journal of Endodontics, 18, 172–177.
10.1016/S0099-2399(06)81413-5
CAS PubMed Web of Science® Google Scholar
Wang, J., Zhao, J.J., Tai, Z.W., Wang, X.C., Tao, J. & Liao, Q. (2023) Assessment of oral emergency services during COVID-19: a retrospective study of 14,885 cases in Shanghai. BMC Oral Health, 23, 834.
10.1186/s12903-023-03563-1
PubMed Web of Science® Google Scholar
Weintraub, J.A., Quinonez, R.B., Smith, A.J.T., Ciarrocca, K., Fouad, A.F., Shazib, M.A. et al. (2020) Responding to a pandemic: development of the Carolina dentistry virtual Oral health care helpline. Journal of the American Dental Association, 151, 825–834.
10.1016/j.adaj.2020.08.003
PubMed Web of Science® Google Scholar
Wu, K., Li, C., Yang, Z., Yang, S., Yang, W. & Hua, C. (2021) Changes in the characteristics of dental emergencies under the influence of SARS-CoV-2 pandemic: a retrospective study. BMC Oral Health, 21, 174.
10.1186/s12903-021-01499-y
CAS PubMed Web of Science® Google Scholar
Yu, J., Zhang, T., Zhao, D., Haapasalo, M. & Shen, Y. (2020) Characteristics of endodontic emergencies during coronavirus disease 2019 outbreak in Wuhan. Journal of Endodontics, 46, 730–735.
10.1016/j.joen.2020.04.001
PubMed Web of Science® Google Scholar
Yu, V.S., Messer, H.H., Yee, R. & Shen, L. (2012) Incidence and impact of painful exacerbations in a cohort with post-treatment persistent endodontic lesions. Journal of Endodontia, 38, 41–46.
10.1016/j.joen.2011.10.006
CAS PubMed Web of Science® Google Scholar

Volume58, Issue7

July 2025

Pages 952-964

Same-day emergencies in endodontic specialists' practice: Before, during and after the COVID-19 pandemic

Abstract

Aim

Methodology

Results

Conclusions

CONFLICT OF INTEREST STATEMENT

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Same-day emergencies in endodontic specialists' practice: Before, during and after the COVID-19 pandemic

Abstract

Aim

Methodology

Results

Conclusions

CONFLICT OF INTEREST STATEMENT

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

References

Related

Information