A multicentre investigation into the role of structured histories for patients with tooth avulsion at their initial visit to a dental hospital

A paper structured history (SH) is a sheet, which prompts or reminds the clinician to ask various important questions. The aim of this study was to examine avulsion cases with respect to the quality of clinical records. Hospitals studied used either a paper SH or had no specific structure in their recording of avulsion details, e.g. unstructured histories (USH). The most important prognostic items that should be recorded for avulsion cases at their first visit were identified by reviewing the literature. Clinical case records meeting strict inclusion criteria were retrospectively analyzed against 10 important prognostic items. Forty-seven patient records were identified in the SH group compared to 43 patient records in the USH group. Using chi-square and Fisher's exact tests, the SH group were significantly better at recording the following: accident details (P < 0.001), loss of consciousness (P < 0.001), other teeth or tooth injuries (P < 0.05), extra-alveolar mediums (P < 0.01), total extra-alveolar time (P < 0.001), antibiotics given at time of injury (P < 0.05) and apical maturity (P < 0.001). In all the dental hospitals selected, two-thirds of the case records were completed by junior dentists not in specialist training and the improvement in history when using an SH form was most pronounced in these groups. It is concluded, therefore, that an SH should be taken for cases ofavulsion as it was significantly better at collecting essential prognostic information.