Sir, the region of Madrid (population 6.6 million) is one of Europe's regions most affected by COVID-19 with around 60,000 cases officially reported (beginning of May). On 14 March 2020 the Spanish Government decreed a state of alarm under which the whole population was subjected to compulsory home confinement. A few days later, the General Dental Council of Spain advised that due to a general shortage of PPE, practices which do not have this equipment available would immediately cease to operate, including cases involving dental emergencies. Consequently, only 5% of the dental clinics remained open for urgent dental care.

We present a preliminary analysis of some aspects of urgent dental care performed by a dentist in this region (17 March-3 May) who was on call 24 hours a day, six days a week, with the support of an assistant. Before an appointment patients underwent a telephone interview by the dentist; none reported COVID-19 symptoms nor contact with infected persons. Following this protocol, patients were then seen at the practice within one hour. Some 25% were treated between midnight and 6 am. The time span between the presentation of symptoms and the request for urgent consultation was usually over ten days. The majority of patients (75%) had received treatment involving only the usual medication. At all times, the dentist used appropriate PPE, minimising the use of aerosol generating procedures.

Total patients seen were 187 (98 women; 89 men; aged 20 months-87 years). Seven were children under the age of 12 and 12 were over 75. The most common diagnosis (50%) was acute periapical periodontitis, with associated abscess (19% of cases), irreversible pulpitis (13%), complications of third molar pericoronitis (7%), periodontal abscesses (6%), vertical fractures (5%), horizontal fractures (5%) and other pathologies.

In 58% of cases an extraction was performed, in 6% a scale and root planing of the pathological area and in 10% of cases only pharmacological treatment was indicated. Other procedures performed were first stage of root canal treatment, root canal treatments of monoradicular teeth, cementing fixed dentures and removal or repair of orthodontic appliances. Only three patients were referred to emergency hospital services. An estimated 80% of treatments provided a permanent resolution of the pathology and in the remaining cases it was possible to offer a partial or temporary solution.

In conclusion, the urgent dental care provided was undoubtedly strenuous, but it was also a source of great satisfaction for the dentist, both personally and professionally. Moreover, the patients greatly appreciated his degree of availability and the importance of the work achieved. After this period the dentist was tested for SARS-COV-2 antibodies and a negative result was received.