I have recently been working in our local A&E department due to redeployment, which has been an incredible learning curve, but has also raised some questions. One thing I couldn't help but notice was the amount of dental problems that present to A&E. As the dental hospital is a mere stone's throw from the emergency department, this was rather confusing. This pattern of presentation would be understandable if it were limited to out of hours, or if it was only occurring due to the inaccessibility to dental services that some patients are currently experiencing, but apparently this is a common occurrence. I have also witnessed this phenomenon in reverse, where patients present to the dentist having already waited for hours in A&E.

So, what brings patients to hospital instead of a dentist? Speaking to patients, some people would rather go anywhere but the dentist. Some people get swellings and worry that it may need medical attention. Occasionally, patients don't seem to realise that it's a dentist that they need to see. Speaking to doctors, they often aren't very comfortable with dental issues, and were generally quite happy if I could be there to assist. So we have uncomfortable patients, uncomfortable doctors and a whole dental hospital full of the necessary equipment and knowledge to help - what's going wrong?

Given that A&E departments aren't generally made for dental emergencies, these patients will inevitably need to come to us to get the necessary treatment. It would make sense that these patients should be sent straight to the dentist on presentation. However, if dental pain patients are sent away, then this leaves all the responsibility with the patient, and could leave hospitals open to a medico-legal nightmare. There also seems to be an 'antibiotics and painkillers' culture, where dental pain isn't totally understood.

While I was there, I was able to speak to staff and give an overview of DPTs, simple treatments with the materials they have, and when to refer on to us. After the onslaught of medical knowledge that I was being taught, it was quite refreshing to feel like I could give something back. I appreciated the opportunity to cross the barrier and to speak to our medical colleagues, and it gave us the chance to understand how we can work together. Being able to share knowledge in this way seemed beneficial for both parties, and is something that could be useful in the future.

So whether it's the patient's dental phobia, a fear of 'not doing something active' or public perception and availability of resources, there are certainly improvements to be made.

Despite the difficult and challenging circumstances, this has been a great experience and I am leaving A&E with a huge sense of respect for our medical colleagues and pride in the NHS.