Role of SDF in Reducing Urgent Care Encounters for Patients Awaiting General Anesthesia

Purpose: Primarily, to analyze how application of silver diamine fluoride (SDF) impacts the odds of presenting to urgent care (UC) while awaiting dental treatment under general anesthesia (GA). Secondarily, to analyze descriptive data from UC visits to identify trends associated with a prolonged GA wait time. Methods: Retrospective chart audit of a sample of patients on the GA waitlist for complete oral rehabilitation from January 1st, 2014 to December 31st, 2016. Data points collected include total GA wait time, SDF application, UC presentation, number of encounters, chief complaint and treatment. Age, dmft, sex, race, ethnicity, and identification as special needs were incorporated into data analysis to identify potential trends. Results: Of 1,219 charts, 661 charts were included for analysis. The average wait for GA was 364.8 days. 171/661 patients (26%) presented to UC during this time with pain being the most common chief complaint (73%) and extraction being the most common treatment (55% of UC encounters); The average time between waitlist placement and UC presentation was 171 days. 153/575 non-SDF patients presented to UC (27%) compared to 18/86 (21%) SDF patients. There was positive correlation between days spent on the GA waitlist and number of UC visits (P = .047). Conclusion: Though odds of presenting to UC were decreased with SDF application, this was not found to be statistically significant. There was a significant correlation between the amount of time spent on the GA waitlist and the number of urgent care encounters. More data points could provide more significant results.