Emergency department visits for infectious oral conditions in Massachusetts, 2014 through 2018

Hospital usage for oral and dental conditions in Hawaii: A cross-sectional study using the 2021 Hawaii statewide hospital data

OBJECTIVE

To investigate the frequency of emergency department (ED) usage primarily for oral/dental conditions in Hawaii and to examine social-demographic factors associated with the identified ED visits.

METHODS

This was a cross-sectional study of the 2021 Hawaii Statewide Hospital data. We identified records indicating ED usage and a primary diagnosis of non-traumatic dental conditions (NTDC) and other oral dental conditions (OODC). Descriptive analyses of ED visits for NTDC and OODC were performed to identify vulnerable individuals based on age, sex, race/ethnicity, primary source of payment, county of residence, and total charges per hospital record. A multivariable negative binomial regression model included age, sex, and county of residence was used to obtain adjusted rate ratios (aRR) and 95% confidence intervals (CI) of ED visits for NTDC.

RESULTS

Among hospital records with diagnoses for oral or dental conditions (n = 12,336), 97% indicated ED, of which half had an NTDC diagnosis, and the remaining half had an OODC diagnosis. Distinct differences in the characteristics of ED visits were observed between NTDC and OODC. The median total charges per record indicating ED for NTDC and OODC were $1439 and $2439, respectively. A higher rate of ED visits for NTDC was found for those aged 21-44 (aRR [95%CI] = 3.02 [2.41, 3.80], reference: 0-9 years) and those living in a less populous county (Hawaii: 1.73 [1.43, 2.07]; Kauai: 1.78 [1.45, 2.19], reference: Honolulu).

CONCLUSIONS

Continued effort to improve dental health is required to reduce ED visits for oral and dental conditions among Hawaii residents, especially for vulnerable individuals.

Variations in temporal trends in non-traumatic dental condition related emergencies

OBJECTIVE

The objective of the study was to investigate temporal trends in non-traumatic dental condition (NTDC) related emergency visits at Emergency Department (ED), urgent care (UC), and at a Federally Qualified Health Center (FQHC) that providing dental services to a mid-sized rural community.

METHODS

Temporal trends over a 9-year period (2008-2016) in NTDC rates at ED, UC, FQHC and in a region around the FQHC were determined. Statistically significant changes (α = 0.05) in the proportion of NTDC visits between FQHC and UC across each of the time points were investigated.

RESULTS

Proportion of NTDC ED visits was relatively stable over the study period; whereas those at FQHC exceeded those at UC site beginning 2012 and were significantly (α = 0.05) higher than that of UC subsequently (2015-2016).

CONCLUSIONS

NTDCs are preventable dental conditions and the care provided in treating NTDCs in emergency settings is palliative and does not address the underlying conditions resulting in poor outcomes. The results presented elucidate the critical role of FQHCs in significantly reducing NTDC visits. These might be precursors to a potential shift in NTDC care seeking behavior and expected to favorably impact oral health outcomes.

Emergency Room Visits with a Non-Traumatic Dental-Related Diagnosis in Hawaii, 2016-2020

The purpose of this study was to characterize the frequencies and patterns of emergency room (ER) visits with a non-traumatic dental-related diagnosis among adults (≥21 years old) in Hawaii, United States. This descriptive cross-sectional study used state-level inpatient and outpatient data recorded in Hawaii from 2016 to 2020. We identified dental-related ER visits using the diagnosis codes for non-traumatic dental-related conditions and summarized the frequency, rates, and cumulative total charges of the ER visits. The results show that approximately 30 thousand ER visits between 2016 and 2020 had a dental-related diagnosis. Sixty-seven percent of them had it as a principal diagnosis, amounting to USD 38.7 million total charges over the five years. A high proportion of these visits was found among those aged 21−44 years old (62%), Medicaid beneficiaries (49%), and Native Hawaiians/Part Native Hawaiians (26%). Compared to the proportions of ER visits with a secondary diagnosis, these groups had a higher proportion of ER visits with a principal diagnosis (ps < 0.001). A higher visit rate was found for those aged 21−44 years old and from less-populated counties. These results suggest that oral health disparities in age, socioeconomic status, and race/ethnicity exist in Hawaii. Our findings could provide insight in developing a framework to reduce oral health disparities, particularly among Medicaid beneficiaries and Native Hawaiians. Dental coverage with effective education in multiple dimensions is necessary to reduce non-traumatic dental-related ER visits.