Epidemiology of dental emergency visits to an urban children's hospital

Abstract

All 1482 emergency room dental visits to Seattle's Children's Hospital and Medical Center from 1982 to 1991 were studied to evaluate trends in patients seeking care: 60% of visits were for trauma, the remainder for infection or other reasons. The number of visits was 2.1 times greater in 1991 than in 1982. Comparing the periods of 1982-1987 and 1988-1991, there was an increase in the proportion of infection-related visits from 30.5 to 43.5% of all visits. Spring/summer and weekends had the highest volume. More males (61.2%) than females received care. The largest number of visits (47.9%) occurred between 6:00 PM and midnight. Nearly two-thirds (62%) of children did not have a usual source of medical care; 30.2% of children had no medical insurance, and 21.5% received Medicaid benefits. Medicaid patients were twice as likely to be seen for infection as for trauma. Among the uninsured, there was no difference in the rates of trauma or infection. Non-Caucasian patients were twice as likely to be seen for infection as Caucasians. Infection visits were for pulpitis (32.1%), and periapical and gingival abscess (53.5%). Trauma patients were younger (66 months) than infection patients (89 months). Trauma was primarily to the maxillary anterior teeth (70.1%) and upper lip and gingiva (12.1%). Common agents for trauma were furniture, bicycles, and sports.