Background: Oral health emergency department (ED) visits are increasing nationally. This increase
in ED admissions is an indicator that preventative dental and oral healthcare practices are
not being utilized. Methods: Data was obtained from the Meadville Medical Center. Fourteen ICD-9
codes for dental and oral health admissions over 10 years were categorized and analyzed. Data
was graphed to illustrate trends over time and the chi-square test of independence was used to
determine associations between admissions types and demographic characteristics. Results: ED
admissions for dental and oral health issues were most common among individuals age 19 - 38
years. Most individuals admitted to the ED for these concerns paid with private medical insurance
or were uninsured. The categorization of ICD-9 codes allowed us to see that ED use for structural
and soft-issues decreased at the end of the decade under study. However, admissions for infections
and dental caries increased over time. Conclusions: The opening of a free dental clinic in
2011 might be associated with the decrease in overall admissions for dental and oral health concerns
as well as soft tissue and structural admissions. The increase in ED admissions for dental caries
and infections illustrates that more affordable and preventative dental and oral health care
and education are need.
References
[1]
DeLia, D., Lloyd, K., Feldman, C.A. and Cantor, J.C. (2015) Patterns of Emergency Department Use for Dental and Oral Health Care: Implications for Dental and Medical Care Coordination. Journal of Public Health Dentistry.
http://onlinelibrary.wiley.com/doi/10.1111/jphd.12103/abstract
[2]
Allareddy, V., Rampa, S., Lee, M.K. and Nalliah, RP. (2014) Hospital-Based Emergency Department Visits Involving Dental Conditions: Profile and Predictors of Poor Outcomes and Resource Utilization. The Journal of the American Dental Association, 145, 331-337. http://www.sciencedirect.com/science/article/pii/S0002817714600106
http://dx.doi.org/10.14219/jada.2014.7
[3]
McCormick, A.P., Abubaker, A.O., Laskin, D.M., Gonzales, M.S. and Garland, S. (2013) Reducing the Burden of Dental Patients on the Busy Hospital Emergency Department. Journal of Oral and Maxillofacial Surgery, 71, 475-478.
http://www.sciencedirect.com/science/article/pii/S0278239112012335
http://dx.doi.org/10.1016/j.joms.2012.08.023
[4]
McKinney, L. and Lee, M.R. (2015) Visits to US Emergency Departments by 20- to 29-Year-Olds with Toothache during 2001-2010. The Journal of the American Dental Association, 146, 302.e2.
[5]
Action for Dental Health. From the Emergency Room to the Dental Chair. American Dental Association Web Site.
http://www.ada.org/en/public-programs/action-for-dental-health/er-referral?source=facebook&content=ADH_ER_1
[6]
(2013) Action for Dental Health: Bringing Disease Prevention into Communities. American Dental Association.
[7]
Wall, T., Nasseh, K. and Vujicic, M. (2014) Majority of Dental-Related Emergency Department Visits LACK Urgency and Can Be Diverted to Dental Office. American Dental Association Health Policy Institute.
http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0814_1.ashx
[8]
Wall, T. and Nasseh, K. (2013) Emergency Department Use for Dental Conditions Continues to Increase. American Dental Association Health Policy Institute.
http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0513_1.ashx
[9]
Seu, K., Hall, K. and Moy, E. (2012) Emergency Department Visits for Dental Related Conditions, 2009 Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project (HCUP) Statistical Brief #143.
http://www.ncbi.nlm.nih.gov/books/NBK116745/pdf/Bookshelf_NBK116745.pdf
[10]
Shortridge, M. (2009) Use of Emergency Departments for Conditions Related to Poor Oral Healthcare: Implications for Rural and Low-Resource Urban Areas for Three States. Journal of Public Health Management and Practice, 15, 238-245. http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00124784-200905000-00010
http://dx.doi.org/10.1097/PHH.0b013e3181a1179f
[11]
WHO (2013) Oral Health Surveys Basic Methods. World Health Organization, 1-125.
[12]
Skillman, S.M., Doescher, M.P., Mouradian, W.E. and Brunson, D.K. (2010) The Challenge to Delivering Oral Health Services in Rural America. Journal of Public Health Dentistry, 70, S49-S57.
http://onlinelibrary.wiley.com/doi/10.1111/j.1752-7325.2010.00178.x/full
http://dx.doi.org/10.1111/j.1752-7325.2010.00178.x
[13]
(Accessed 9 July 2015) Crawford County Pennsylvania QuickFacts from the US Census Bureau. United States Census Bureau Web Site. http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk
[14]
(Accessed 9 July 2015) Meadville (city) Pennsylvania QuickFacts from the US Census Bureau. United States Census Bureau Web Site. http://quickfacts.census.gov/qfd/states/42/4248360.html
[15]
Vanderbilt, A.A., Isringhausen, K.T., VanderWielen, L.M., Wright, M.S., Slashcheva, L.D. and Madden, M.A. (2013) Health Disparities among Highly Vulnerable Populations in the United States: A Call to Action for Medical and Oral Health Care. Medical Education Online, 18, Article ID: 20644.
http://www.med-ed-online.net/index.php/meo/article/view/20644
http://dx.doi.org/10.3402/meo.v18i0.20644
[16]
Jones, E., Shi, L.Y., Hayashi, A.S., Sharma, R., Daly, C. and Ngo-Metzger, Q. (2013) Access to Oral Health Care: The Role of Federally Qualified Health Centers in Addressing Disparities and Expanding Access. American Journal of Public Health, 103, 488-493. http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.300846
http://dx.doi.org/10.2105/AJPH.2012.300846
[17]
Kenney, G.M., McFeeters, J.R. and Yee, J.Y. (2005) Preventive Dental Care and Unmet Dental Needs among Low- Income Children. American Journal of Public Health, 95, 1360-1366.
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2004.056523
http://dx.doi.org/10.2105/AJPH.2004.056523
[18]
Dye, B., Thornton-Evans, G., Li, X. and Lafolla, T. (2015) Dental Caries and Tooth Loss in adults in the United States, 2011-2012. Centers of Disease Control and Prevention: National Center for Health Statistics, No. 197, 1-8.
http://www.cdc.gov/nchs/data/databriefs/db197.pdf
[19]
Vujicic, M., Yarbrough, C. and Nasseh, K. (2014) The Effect of the Affordable Care Act’s Expanded Coverage Policy on Access to Dental Care. Medical Care, 52, 715-719.
http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00005650-201408000-00007
http://dx.doi.org/10.1097/MLR.0000000000000168
[20]
(2010) One Hundred Eleventh Congress of the United Stated of America. Patient Protection and Affordable Care Act.
http://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf
[21]
Cook, A.A. (7 July 2015) Dental ER Visits Draw Advice from Groups. The Courier-Journal.
http://www.courier-journal.com/story/opinion/readers/2015/07/07/letters-dental-er-visits-draw-advice-groups/29807695/
[22]
(2010) America’s Oral Health: The Role of Dental Benefits. Delta Dental Insurance.
[23]
United States Department of Health and Human Services (Accessed 20 July 2015) The Affordable Car Act and Health Centers Health Resources and Services Administration Web site. http://bphc.hrsa.gov/about/healthcenterfactsheet.pdf
[24]
(Accessed 20 July 2015) Healthy People 2020: Oral Health Objectives. Office of Disease Prevention and Health Promotion Web Site. http://www.healthypeople.gov/2020/topics-objectives/topic/oral-health/objectives
[25]
(Accessed 11 July 2015) Community Health Services: Meadville Dental Center. Meadville Medical Center Web Site.
http://www.MeadvilleMedicalCenterhs.org/Services/CommunityHealthServices/FamilyPlanningServices /DentalCenters/MeadvilleDentalCenter.aspx
[26]
Jasek, J.P., Hosseinipour, N., Rubin, T. and Lall, R. (2013) Using Syndromic Emergency Department Data to Augment Oral Health Surveillance. Online Journal of Public Health Informatics, 5.
http://journals.uic.edu/ojs/index.php/ojphi/article/view/4407
http://dx.doi.org/10.5210/ojphi.v5i1.4407
