Implementation of photographic triage in a paediatric dental, orthodontic and maxillofacial department during COVID-19.

Davies, Anna; Howells, Ryan; Lee, S M G; Sweet, C J; Dominguez-Gonzalez, S

BACKGROUND During the COVID-19 pandemic, limitations were placed on face-to-face encounters in dentistry and oral and maxillofacial surgery (OMFS) in order to promote physical distancing and reduce viral propagation. To facilitate continued assessment of dental, orthodontic and maxillofacial emergencies a photographic triage system was initiated at Alder Hey Children's Hospital (AHCH). We will discuss the benefits this system offers at a patient, clinician, departmental and NHS service level. AIM To share our experience of photographic triage during the first three months of COVID-19 lockdown, lessons learned and recommendations. DESIGN Prospective data collection over 3 months. RESULTS 220 photographic referrals were received, swelling (30%) and dental trauma (27%) were the commonest presenting complaints. 57% of referrals were not seen, 23% were seen semi-urgently and 20% booked for outpatient review. Of those seen, 7 children were seen elsewhere and 44 were seen face-to-face at AHCH, with 8 being admitted. CONCLUSION Photographic triage reduced physical encounters, and proved useful in training junior staff, assessment of new patient referrals and non-resident on-calls. Implementation should be considered throughout dental, orthodontic and OMFS departments nationwide. In the event of a COVID-19 resurgence or emergence of a new pandemic, photographic triage could facilitate physical distancing and service provision.