The World Health Organization (WHO) declared the COVID-19 pandemic in March 2020. The outbreak and the subsequent lockdown were a difficult period also for pediatric dentistry. The SARS-CoV-2 virus spreads through droplets and is transmitted through direct contact with the mucous membranes of the mouth, nose and eyes. Since the virus is stable outside the host’s body, infection can also occur in the case of indirect contact with contaminated tools, equipment and surfaces. The SARS-CoV-2 virus can bind to angiotensin-converting enzyme 2 (ACE-2) receptors, which are also abundant in the salivary glands. The work of a dentist involves direct exposure to the patient’s body fluids (blood, lymph, saliva). Additionally, the use of high-speed turbine contra angle handpieces, water-air syringes, and ultrasonic scalers during dental procedures gives rise to aerosol, which is a mixture of water, blood and saliva, contaminating the air, surfaces and equipment (1, 2). Therefore, both dental patients and personnel were at increased risk of transmitting the virus. Due to the lack of international consensus on the criteria for providing dental services, many countries restricted access to or strongly discouraged the provision of dental services during the first outbreak of COVID-19 (3). However, patients requiring emergency dental care were not left behind. The criteria for admitting patients in emergency situations were specified in the recommendations for pediatric dentists issued by, among others, Polish and British dental associations (4, 5). They specified the conditions for admitting patients for emergency visits and the process of qualifying dental patients in a non-contact form. Patients were admitted after a prior medical and epidemiological interview. Those reporting electively and those with a history of influenza-like symptoms (dyspnoea, cough, elevated body temperature, rhinitis) were not qualified for a visit. Teleconsultations were not only a tool for prioritizing dental cases, but they also allowed for providing medical advice, issuing e-prescriptions or sick leaves also in the case of an interview that excluded the possibility of admission (6). The aim of the study was to assess the effectiveness of teleconsultations as a tool for establishing a preliminary diagnosis, classifying patients depending on their treatment needs and epidemiological status (SARS-CoV-2 infection).

The aim of the study was to assess the effectiveness of dental teleconsultations as a tool for establishing a preliminary diagnosis, as well as for clinical and epidemiological classification of patients during the COVID-19 pandemic.

The study used medical records of patients who had a telephone consultation with interns at the Pediatric Dentistry Clinic of the University Dentistry Centre of the Medical Centre of the Medical University of Warsaw at 6 Binieckiego Street between April 1 and June 30, 2020. The qualification criteria for a dental visit are summarised in table 1.

The following data were obtained from the records of teleconsulting patients: date of consultation, initials, date of birth, gender, reason for the teleconsultation. Based on the initial diagnosis, two groups of patients were distinguished:

• Group A: patients who did not require urgent medical intervention and were given telephone advice and/or were recommended treatment after the epidemic threat ceased.

• Group B: patients requiring urgent medical intervention who have been advised to visit a dental office.

Patients who qualified for treatment but did not report to the office were assigned to the third group (group C). Patients reporting for treatment completed a COVID-19 questionnaire and were verified in the registration system in accordance with the requirements applicable during the pandemic threat. Another medical interview was performed. Patients qualified for treatment underwent clinical examination and additional investigations if needed. Based on the data collected, a diagnosis was made and appropriate treatment was started. The concordance between remote diagnoses based on a medical history and the diagnoses established during medical appointment was assessed.

The study involved a total of 180 patients aged 8.31 ± 4.79 years, including 80 (44.4%) girls and 100 (55.6%) boys. Based on the teleconsultation, 149 (82.7%) patients were qualified for further treatment at the Department of Pediatric Dentistry (Medical University of Warsaw). Of those qualified for urgent treatment, only 89 (59.7%) patients reported to the Department, whereas 60 (40.3%) qualified patients did not continue further treatment. A total of 31 (17.3%) patients were not qualified for emergency treatment. The characteristics of study participants (Group A – unqualified; Group B – qualified; Group C – subgroup of Group B, qualified patients who missed their appointment) are presented in table 2.