Emergency department visits for nontraumatic dental conditions: a systematic literature review

• Published in: Journal of public health dentistry Vol. 80; no. 4; pp. 313 - 326
• Main Authors: Akinlotan, Marvellous A., Ferdinand, Alva O.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.09.2020; Wiley Subscription Services, Inc
• Subjects: Aged; Child; Children; Chronic illnesses; dental; Dental Care; Dental insurance; Dental sealants; Dentistry; emergency departments; Emergency medical care; Emergency Service, Hospital; Health care; Humans; Income; Literature reviews; Medicaid; Medicaid programs; Medically Uninsured; Meta-analysis; oral health; Public health; Subpopulations; systematic review; toothache; Uninsured people; United States; Young Adult; Young adults; United States; Medicaid programs; dental; toothache; dental care; dental insurance; meta-analysis; oral health; emergency departments; systematic review
• ISSN: 0022-4006; 1752-7325
• DOI: 10.1111/jphd.12386

Objective To summarize the literature on factors associated with emergency department (ED) use for nontraumatic dental conditions (NTDCs). Methods Following a database search, empirical studies were included if they examined factors associated with ED visits for NTDCs. The factors identified in these studies were further categorized using the Andersen Behavioral Model. Where appropriate, odds ratios (ORs) predicting the likelihood of NTDC ED visits were extracted to obtain summary estimates using random effects models. Results Sixty‐three articles were included. Nontraumatic dental ED visits made up about 2.2 percent of all ED visits. Having public health insurance coverage such as Medicaid [OR = 2.17, 95 percent confidence interval (CI) = 1.79–2.64], and being uninsured (OR = 2.80, 95 percent CI = 2.39–3.39) were predictive of ED visits for NTDCs. Adults were more likely to use the ED for NTDCs compared to children and older adults. Rural adults had increased odds of ED use for NTDCs compared to urban adults (OR = 1.31, 95 percent CI = 1.12–1.52). Among younger children, regular dental care without sealant placement was associated with increased ED use for NTDCs. In the United States, both expansion and restriction of Medicaid dental coverage for adults were associated with increased ED visits for NTDCs. Conclusions Policy makers and health care providers should address modifiable factors such as accessible dental care for the uninsured, and comprehensive dental coverage for those with public dental benefits. Targeted interventions should focus on young adults, children with special needs, and subpopulations with low socioeconomic status and chronic health conditions.