Medications prescribed in emergency departments for nontraumatic dental condition visits in the United States

Abstract

Background: Prior research has documented factors associated with nontraumatic dental condition (NTDC) visits to emergency departments (EDs), but little is known about the care received by patients in EDs for NTDC visits.

Objective: We examined national trends in prescription of analgesics and antibiotics in EDs for NTDC visits in the United States.

Research design: We analyzed data from the National Hospital Ambulatory Medical Care survey from 1997 to 2007. We used a multivariable logistic regression model to examine factors associated with receiving analgesics and antibiotics for NTDC visits in EDs.

Results: Overall 74% received at least 1 analgesic, 56% received at least 1 antibiotic, and 13% received no medication at all during NTDC visits to EDs. The prescription of medications at EDs for NTDC visits steadily increased over time for analgesics (odds ratio=1.11/y, P<0.0001) and antibiotics (odds ratio=1.06/y, P<0.0001). In the multivariable analysis, self-pay patients had significantly higher adjusted odds of receiving antibiotics, whereas those with nondental reasons for visits and children (0-4 y) had significantly lower adjusted odds of receiving a prescription for antibiotics in EDs for NTDC visits. Children (0-4 y), adults (53-72 y), and older adults (73 y and older) had lower adjusted odds (P<0.001) of receiving analgesics.

Conclusions: Nationally, analgesic and antibiotic prescriptions for NTDC visits to EDs have increased substantially over time. Self-pay patients had significantly higher odds of being prescribed antibiotics. Adults over 53 years and especially those 73 years and older had significantly lower odds of receiving analgesics in EDs for NTDC visits.

Figure 1

Venn diagram of Medication including Analgesic and Antibiotics Received for NTDC visits at the ED, 1997–2007. The percentages represent the survey-weighted proportions for the different medications prescribed for NTDC visits. The percentages add up to 100%.

Figure 2

Percentages of Different Medications Prescribed for NTDC Visits by Age, Payer Type, Race/ethnicity and Calendar Year Abx – antibiotic; Ag – analgesic, A/A – antibiotic or analgesic; Any – any medication. *** - <0.001, ** - <0.01, * - <0.05.