Visiting the emergency department for dental problems: trends in utilization, 2001 to 2008

Abstract

Objectives: We tested the hypothesis that between 2001 and 2008, Americans increasingly relied upon emergency departments (EDs) for dental care.

Methods: Data from 2001 through 2008 were collected from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Population-based visit rates for dental problems, and, for comparison, asthma, were calculated using annual US Census Bureau estimates. As part of the analysis, we described patient characteristics associated with large increases in ED dental utilization.

Results: Dental visit rates increased most dramatically for the following subpopulations: those aged 18 to 44 years (7.2-12.2 per 1000, P < .01); Blacks (6.0-10.4 per 1000, P < .01); and the uninsured (9.5-13.2 per 1000, P < .01). Asthma visit rates did not change although dental visit rates increased 59% from 2001 to 2008.

Conclusions: There is an increasing trend in ED visits for dental issues, which was most pronounced among those aged 18 to 44 years, the uninsured, and Blacks. Dental visit rates increased significantly although there was no overall change in asthma visit rates. This suggests that community access to dental care compared with medical care is worsening over time.

FIGURE 1—

ED visit rates (per 1000) by (a) age, (b) race/ethnicity, and (c) insurance: National Hospital Ambulatory Medical Care Survey, United States, 2001–2008. Note. ED = emergency department *P < .05 for trend

FIGURE 2—

Trends in ED dental visits and national unemployment: National Hospital Ambulatory Medical Care Survey, United States, 2001–2008. Note. ED = emergency department.

FIGURE 3—

Change in dental, asthma, and all ED visit rates relative to 2001 baseline values: National Hospital Ambulatory Medical Care Survey, United States, 2001–2008. Note. ED = emergency department. Rates/1000 for years 2001 and 2008 were 3.7 and 5.9, respectively, for dental visits; 9.1 and 9.1, respectively, for asthma-related visits; and 377.1 and 406.6, respectively, for all ED visits.