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. 2015 May;146(5):295-302.e2.
doi: 10.1016/j.adaj.2015.01.013.

Visits to US emergency departments by 20- to 29-year-olds with toothache during 2001-2010

Charlotte W Lewis, Christy M McKinney, Helen H Lee, Molly L Melbye, Tessa C Rue

Visits to US emergency departments by 20- to 29-year-olds with toothache during 2001-2010

Charlotte W Lewis et al. J Am Dent Assoc. 2015 May.

Abstract

Background: Visits to emergency departments (EDs) for dental symptoms are on the rise, yet reliance on EDs for dental care is far from ideal. ED toothache visits represent opportunities to improve access to professional dental care.

Methods: This research focuses on 20- to 29-year-olds, who account for more ED toothache visits than do other age groups. The authors analyzed publicly available ED visit data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2001 through 2010. They assessed trends in ED toothache visit rates compared with back pain and all cause ED visits during the past decade. The authors used NHAMCS data for years 2009 and 2010 to characterize the more recent magnitude, relative frequency, and independent risk factors for ED toothache visits. Statistical analyses accounted for the complex sampling design.

Results: The average annual increase in ED visit rates among 20- to 29-year-olds during 2001-2010 was 6.1% for toothache, 0.3% for back pain, and 0.8% for all causes of ED visits. In 2009 and 2010, 20- to 29-year-olds made an estimated 1.27 million ED visits for toothaches and accounted for 42% of all ED toothache visits. Toothache was the fifth most common reason for any ED visit and third most common for uninsured ED visits by 20- to 29-year-olds. Independent risk factors for ED toothache visits were being uninsured or Medicaid-insured.

Conclusions: Younger adults increasingly rely on EDs for toothaches-likely because of barriers to accessing professional dental care. Expanding dental coverage and access to affordable dental care could increase options for timely dental care and decrease ED use for dental symptoms.

Practical implications: Though additional research is needed to better understand why younger adults disproportionately use the ED for toothaches, findings from this study suggest the importance of maintaining access to a dental home from childhood through adolescence and subsequently into early adulthood.

Keywords: Access to care; emergency services; emergency treatment; toothache.

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Figures

Figure 1
Figure 1
Percent change in rate of emergency department (ED) visit rates for toothache compared with all-causes and back pain among 20–29 year-olds from 2001 through 2010. NHAMCS, US. Between 2000 and 2010, ED toothache visits increased at a substantially higher rate than either all-cause or back pain ED visit among 20–29 year-olds.
Figure 2
Figure 2
Weighted percentage of emergency department (ED) visits with toothache as leading reason-for-visit, by age category. Weighted odds ratio (OR) and 95% confidence interval (CI) of ED toothache visit by age category (20–29 year-olds are reference category). NHAMCS, US, 2009–2010. In 2009–2010, 20–29 year-olds had a statistically significantly higher odds of an ED toothache visit relative to other age groups.
See this image and copyright information in PMC

Comment in

  • Authors' response.
    Lewis C, McKinney C, Melbye M, Rue T, Lee H. Lewis C, et al. J Am Dent Assoc. 2015 Sep;146(9):655-6. doi: 10.1016/j.adaj.2015.07.010. J Am Dent Assoc. 2015. PMID: 26314970 No abstract available.
  • Emergency toothache.
    Speiser AM. Speiser AM. J Am Dent Assoc. 2015 Sep;146(9):655. doi: 10.1016/j.adaj.2015.07.009. J Am Dent Assoc. 2015. PMID: 26314971 No abstract available.
  • Emergency dental blocks.
    Boccuzzi J. Boccuzzi J. J Am Dent Assoc. 2015 Sep;146(9):655. doi: 10.1016/j.adaj.2015.07.008. J Am Dent Assoc. 2015. PMID: 26314972 No abstract available.
  • Maintaining standards.
    Britton DA. Britton DA. J Am Dent Assoc. 2015 Sep;146(9):656. doi: 10.1016/j.adaj.2015.07.011. J Am Dent Assoc. 2015. PMID: 26314973 No abstract available.
  • Authors' response.
    Lewis C, McKinney C, Melbye M, Rue T, Lee H. Lewis C, et al. J Am Dent Assoc. 2015 Sep;146(9):656. doi: 10.1016/j.adaj.2015.07.012. J Am Dent Assoc. 2015. PMID: 26314974 No abstract available.

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