Dental complaints in emergency departments: a national perspective. 2003

Charlotte Lewis, and Heather Lynch, and Brian Johnston
Child Health Institute, Department of Pediatrics, University of Washington, 6200 NE 74th Street, Building 29, Seattle, WA 98115, USA. clewis19@u.washington.edu

OBJECTIVE Using nationally representative data, we sought to describe the incidence of emergency department (ED) visits for dental-related complaints for children and adults in the United States. We hypothesized that dental-related ED visits were more likely than other ED visits to have Medicaid or no insurance as the payer. METHODS We used data from the 1997 to 2000 National Hospital Ambulatory Medical Care Survey, a national probability sample survey of hospital ED visits that is conducted by the National Center for Health Statistics. From these data, all ED visits in which one of the reasons for the visit was toothache or tooth injury were compiled and used to determine national estimates of counts and rates of ED visits for dental-related complaints. Logistic regression analysis on the outcome variable, presentation to the ED with a dental complaint (versus other problem), was performed to determine the association with payer and other covariates. RESULTS During the 4-year period from 1997 to 2000, there were an estimated 2.95 million ED visits in the United States for complaints of tooth pain or tooth injury, for an average of 738,000 visits annually. Population-based rates and proportion of all ED visits for dental complaints were highest in the 19- to 35-year-old group, accounting for 1.3% of all ED visits and 5.6 ED visits per 1,000 people in this age category. "Dental problem, not otherwise specified" was the most commonly assigned International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis. Multivariate logistic regression results indicated that the adjusted odds of presentation to the ED for a dental complaint compared with other problems were significantly elevated for visits in which Medicaid or self-pay was listed as the payer relative to those with private insurance. CONCLUSIONS EDs are an important point of care for dental-related complaints, particularly for individuals who lack private insurance. ED providers should be equipped to triage, diagnose, provide basic treatment, and ensure appropriate follow-up care for dental problems, which may require enhancement of dental training for emergency medicine providers and improved dental care during and after ED visits.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004636 Emergency Service, Hospital Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient. Emergency Outpatient Unit,Emergency Services Utilization,Hospital Emergency Room,Hospital Emergency Service,Hospital Emergency Services Utilization,Accident and Emergency Department,Emergency Departments,Emergency Hospital Service,Emergency Room,Emergency Units,Emergency Ward,Hospital Service Emergency,Service, Hospital Emergency,Department, Emergency,Departments, Emergency,Emergencies, Hospital Service,Emergency Department,Emergency Hospital Services,Emergency Outpatient Units,Emergency Room, Hospital,Emergency Rooms,Emergency Rooms, Hospital,Emergency Services, Hospital,Emergency Unit,Emergency Wards,Emergency, Hospital Service,Hospital Emergency Rooms,Hospital Emergency Services,Hospital Service Emergencies,Hospital Service, Emergency,Hospital Services, Emergency,Outpatient Unit, Emergency,Outpatient Units, Emergency,Room, Emergency,Room, Hospital Emergency,Rooms, Emergency,Rooms, Hospital Emergency,Service Emergencies, Hospital,Service Emergency, Hospital,Service, Emergency Hospital,Services Utilization, Emergency,Services Utilizations, Emergency,Services, Emergency Hospital,Services, Hospital Emergency,Unit, Emergency,Unit, Emergency Outpatient,Units, Emergency,Units, Emergency Outpatient,Utilization, Emergency Services,Ward, Emergency,Wards, Emergency
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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