A state‐wide study of dental comorbidities in psychiatric disorders resulting in avoidable emergency department presentations

Abstract

Background: Attendances at emergency departments (EDs) for dental conditions are unnecessary and come at a significant cost to health services. Methods: A population-based record-linkage analysis of a retrospective cohort over 2 years across state-based facilities in Queensland. This was to determine if people with mental illness were more likely than the general population to attend EDs for a range of non-traumatic or avoidable dental conditions. Results: There were 1 381 428 individuals in the linked database, of whom 177 157 (13%) had a psychiatric history and 22 046 (1.5%) had one or more avoidable dental presentations. These were toothache (n = 9619), dental abscesses (n = 8449), caries (n = 1826), stomatitis (n = 1213) and gum disease (n = 939). After adjusting for confounders, psychiatric patients were significantly more likely to present with toothache, dental abscesses and caries but not stomatitis or gum disease. Depending on the dental outcome, other risk factors were male sex, lower income, rurality and Indigenous status. Conclusions: Given these findings, possible interventions should include an increased emphasis on assessing oral health in mental health or primary care, especially in non-metropolitan areas, as well as early dental referral. Service planning for this population should including easier navigation of dental services, availability outside normal office hours and free outreach dental clinics.

Medical profile of patients referred to an Australian postgraduate oral surgery clinic

“…Queensland also had the highest prevalence of psychiatric conditions (22.7%) in Australia, with an overall prevalence of 20.1% (Australian Bureau of Statistics, 2022 , 2018 ). Tellingly, data (Kisely et al, 2015 , 2021 ; Kisely & Lalloo, 2021 ) from the state's hospitals revealed that dental conditions accounted for the third most common reason for hospitalization in people with psychiatric conditions, and people with a history of psychiatric treatment were 72% more likely than the rest of the population to present to emergency departments with an avoidable dental condition.…”

Mental health screening and referral to treatment in dental practices: A scoping review

“…[23][24][25][26] MH conditions are related to increased edentulism, 27 reduced oral healthcare services utilization, 28,29 more missed appointments, 29 increased risk of inappropriate dental treatments, 30 and generational influences on children's toothbrushing behaviors. 31 To address these comorbidities, some authors 25,32 suggest a closer association between dental, primary, and MH care providers, which could increase access to care, reduce difficulty in receiving care, and focus on holistic care.…”