Dental-related Emergency Department Visits and Community Dental Care Resources for Emergency Room Patients

Authors

  • Anna Trikhacheva University at Buffalo
  • Michael Page
  • Holly Gault
  • Rose Ochieng
  • Bradley E Barth
  • Chad M Cannon
  • Olga Shakhnovich
  • Kimberly K Engelman

DOI:

https://doi.org/10.17161/kjm.v8i2.11521

Keywords:

emergency medical services, dental care, oral health, medically uninsured

Abstract

BACKGROUND: The number and cost of dental-related visits to Emergency Departments (ED) is a significant issue nationwide. A better understanding of the treatment provided to ED patients presenting with dental complaints and community dental resources is needed. METHODS: A three-tiered approach included: 1) a 12-month retrospective chart review for dental-related ICD-9 visit codes at an urban academic ED in Kansas City; 2) surveys of 30 providers at the same ED regarding the dental patient process and treatment; and 3) telephone surveys of 16 Kansas City area safety net clinics regarding service access. RESULTS: Out of 49,276 ED visits, 676 were related to dental conditions (70 were repeat dental ED visits). Most patients were female (54%), white (45%), age 20-39 (65%), and self-pay (56%). The most prevalent codes utilized were dental disorder not otherwise specified (NOS; 57%), periapical abscess (22%), and dental caries NOS (15%). Nearly all providers (97%) felt comfortable seeing patients with dental complaints. Chart review indicated that patients received a dental screen/exam during 80% of the encounters, with medication provided to 90% of the patients. Over two-thirds of the providers (N = 23/30) regularly prescribed antibiotics and pain medications for their ED dental patients. ED providers performed dental procedures in 63% of the patient cases. The most common procedures included dental blocks (N = 16 providers) and incision and drainage (N = 4 providers). Only two of the 16 safety net clinics provided comprehensive dental care, almost all (94%) clinics required patients to call to schedule an appointment, and there was a two to six month waiting period for 31% of the clinics. CONCLUSION: The limited scope of dental treatment in the ED, coupled with poor availability of safety-net dental resources, may result in dental exacerbations and suboptimal patient clinical outcomes. The enhancement of safety-net dental service accessibility is crucial to reducing dental ED visits and improving dental health, particularly among low-income, self-pay populations.

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Published

2015-05-18

How to Cite

Trikhacheva, A., Page, M., Gault, H., Ochieng, R., Barth, B. E., Cannon, C. M., Shakhnovich, O., & Engelman, K. K. (2015). Dental-related Emergency Department Visits and Community Dental Care Resources for Emergency Room Patients. Kansas Journal of Medicine, 8(2), 61–72. https://doi.org/10.17161/kjm.v8i2.11521

Issue

Section

Original Research