Patient characteristics and trends in nontraumatic dental condition visits to emergency departments in the United States

Abstract

We examined trends and patient characteristics for non-traumatic dental condition (NTDC) visits to emergency departments (EDs), and compared them to other ED visit types, specifically non-dental ambulatory care sensitive conditions (non-dental ACSCs) and non-ambulatory care sensitive conditions (non-ACSCs) in the United States. Methods: We analyzed data from the National Hospital Ambulatory Medical Care survey (NHAMCS) for 1997 to 2007. We performed descriptive statistics and used a multivariate multinomial logistic regression to examine the odds of one of the three visit types occurring at an ED. All analyses were adjusted for the survey design. Results: NTDC visits accounted for 1.4% of all ED visits with a 4% annual rate of increase (from 1.0% in 1997 to 1.7% in 2007). Self-pay patients (32%) and Medicaid enrollees (27%) were over-represented among NTDC visits compared to non-dental ACSC and non-ACSC visits (P , 0.0001). Females consistently accounted for over 50% of all types of ED visits examined. Compared to whites, Hispanics had significantly lower odds of an NDTC visit versus other visit types (P , 0.0001). Blacks had significantly lower odds of making NDTC visits when compared to non-dental ACSC visits only (P , 0.0001). Compared to private insurance enrollees, Medicaid and self-pay patients had 2-3 times the odds of making NTDC visits compared to other visit types. Conclusion: Nationally, NTDC visits to emergency departments increased over time. Medicaid and self-pay patients had significantly higher odds of making NDTC visits.

Prescription of opioid analgesics for nontraumatic dental conditions in emergency departments

“…This was in line with previous studies conducted by our research team as well as in other published studies that have analyzed dental visits to EDs and physicians' offices (Okunseri et al, 2008; 2011; 2012a; 2012b). Specifically, the following ICD-9-CM (International Classification of Diseases, 9 th revision, Clinical Modification) codes were considered to be NTDC-related visits: 521.0-521.9 (diseases of dental hard tissues of teeth), 522.0-522.9 (diseases of pulp and periapical tissues), 523.0-523.9 (gingival and periodontal diseases), 525.3 (retained dental root), and 525.9 (unspecified disorder of the teeth and supporting structures) based on previous publication on the topic by researchers (Okunseri et al, 2008; 2011; 2012a; 2012b). The Medical College of Wisconsin and the Marquette University Institutional Review Boards approved the study as exempt.…”

“…Nontraumatic dental condition (NTDC) visits to emergency departments is increasing and has become a subject of discussion by researchers, clinicians, policymakers and organized dentistry (Okunseri et al, 2012a, 2012b, Allareddy et al, 2014). This increase in NTDC visits is of serious concern to all stakeholders because emergency departments are not set up to provide routine dental care nor are some ED physicians trained to provide extractions or endodontic treatment (Okunseri et al, 2012a).…”

Nontraumatic dental condition-related visits to emergency departments on weekdays, weekends and night hours: findings from the National Hospital Ambulatory Medical Care Survey

“…Based on NTDC-related ED visit publications,1,5,6,14 the following ICD-9-CM codes were used: 521.0–521.9 (diseases of dental hard tissues of teeth), 522.0–522.9 (diseases of pulp and periapical tissues), 523.0–523.9 (gingival and periodontal diseases), 525.3 (retained dental root), and 525.9 (unspecified disorder of the teeth and supporting structures) 1,5,6,14. Additional covariates included information on age, sex, insurance, patient-stated reason for visit, calendar year, region, location in a Metropolitan Statistical Area, and hospital ownership.…”

“…Nontraumatic dental condition-related emergency department (ED) visits have increased substantially over time in the United States 1–3. Information on the time of day and day of week that patients visit EDs for nontraumatic dental conditions (NTDCs) is scanty and poorly documented.…”

Racial and ethnic variations in waiting times for emergency department visits related to nontraumatic dental conditions in the United States

“…Nationally, nontraumatic dental condition visits to emergency departments increased at an average annual rate of 4%, and by 54% between 1997 and 2007. 4 This increase is of concern to healthcare advocates given that most nontraumatic dental conditions are best managed by dental providers and are preventable with early intervention, sustainable home care and the availability of appropriate access to dental care. Additionally, the non-availability of wait time information for NTDC visits in EDs impedes the understanding of their implications on the health care system, cost of care and practice.…”