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Emergency department visits for nontraumatic dental problems: A mixed-methods study

Author

Listed:
  • Sun, B.C.
  • Chi, D.L.
  • Schwarz, E.
  • Milgrom, P.
  • Yagapen, A.
  • Malveau, S.
  • Chen, Z.
  • Chan, B.
  • Danner, S.
  • Owen, E.
  • Morton, V.
  • Lowe, R.A.

Abstract

Objectives: We documented emergency department (ED) visits for nontraumatic dental problems and identified strategies to reduce ED dental visits. Methods. We used mixed methods to analyze claims in 2010 from a purposive sample of 25 Oregon hospitals and Oregon's All Payer All Claims data set and interviewed 51 ED dental visitors and stakeholders from 6 communities. Results: Dental visits accounted for 2.5% of ED visits and represented the second-most-common discharge diagnosis in adults aged 20 to 39 years, were associated with being uninsured (odds ratio [OR] = 5.2 [reference: commercial insurance]; 95% confidence interval [CI]=4.8, 5.5) or having Medicaid insurance (OR=4.0; 95% CI=3.7, 4.2), resulted in opioid (56%) and antibiotic (56%) prescriptions, and generated $402 (95% CI= $396, $408) in hospital costs per visit. Interviews revealed health system, community, provider, and patient contributors to ED dental visits. Potential solutions provided by interviewees included Medicaid benefit expansion, care coordination, water fluoridation, and patient education. Conclusions: Emergency department dental visits are a significant and costly public health problem for vulnerable individuals. Future efforts should focus on implementing multilevel interventions to reduce ED dental visits.

Suggested Citation

  • Sun, B.C. & Chi, D.L. & Schwarz, E. & Milgrom, P. & Yagapen, A. & Malveau, S. & Chen, Z. & Chan, B. & Danner, S. & Owen, E. & Morton, V. & Lowe, R.A., 2015. "Emergency department visits for nontraumatic dental problems: A mixed-methods study," American Journal of Public Health, American Public Health Association, vol. 105(5), pages 947-955.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2014.302398_3
    DOI: 10.2105/AJPH.2014.302398
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    Citations

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    Cited by:

    1. Emmett Henderson & Preeti Dalawari & Jennifer Fitzgerald & Leslie Hinyard, 2018. "Association of Oral Health Literacy and Dental Visitation in an Inner-City Emergency Department Population," IJERPH, MDPI, vol. 15(8), pages 1-10, August.
    2. Triantafillos Loutroukis & Ekaterini Loutrouki & Jolanta Klukowska-Rötzler & Sabine Koba & Fabian Schlittler & Benoit Schaller & Aristomenis K. Exadaktylos & Michael Doulberis & David S. Srivastava & , 2020. "Violence as the Most Frequent Cause of Oral and Maxillofacial Injuries among the Patients from Low- and Middle-Income Countries—A Retrospective Study at a Level I Trauma University Emergency Departmen," IJERPH, MDPI, vol. 17(13), pages 1-12, July.
    3. Masako Matsunaga & John J. Chen & Patrick Donnelly & Carlotta Ching Ting Fok & Nancy S. Partika, 2022. "Emergency Room Visits with a Non-Traumatic Dental-Related Diagnosis in Hawaii, 2016–2020," IJERPH, MDPI, vol. 19(5), pages 1-8, March.
    4. Pearl C. Kim & Wenlian Zhou & Shawn J. McCoy & Ian K. McDonough & Betty Burston & Marcia Ditmyer & Jay J. Shen, 2019. "Factors Associated with Preventable Emergency Department Visits for Nontraumatic Dental Conditions in the U.S," IJERPH, MDPI, vol. 16(19), pages 1-9, September.
    5. Stormon, N. & Pradhan, A. & McAuliffe, A. & Ford, P.J., 2018. "Does a facilitated pathway improve access to dental services for homeless and disadvantaged adults?," Evaluation and Program Planning, Elsevier, vol. 71(C), pages 46-50.
    6. Chad D. Meyerhoefer & Samuel H. Zuvekas & Bita Fayaz Farkhad & John F. Moeller & Richard J. Manski, 2019. "The demand for preventive and restorative dental services among older adults," Health Economics, John Wiley & Sons, Ltd., vol. 28(9), pages 1151-1158, September.

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