Hospital-based Emergency Department Visits with Dental Conditions among Children in the United States: Nationwide Epidemiological Data

Purpose: To provide nationally representative estimates of hospital-based emergency department visits (ED) for dental caries, pulp and periapical lesions, gingival/periodontal lesions, and mouth cellulitis occurring among patients who were 21 years old and younger. Methods: Nationwide Emergency Department Sample (NEDS) for the year 2008 was used. All ED visits with dental conditions were included. Discharge patterns, demographics, disposition following ED visit, and hospital charges, were examined. NEDS is a uniform, stratified dataset, and can be projected to the national level. Results: A total of 215,073 ED visits with dental conditions occurred among children. These visits included diagnosis of dental caries (50 percent of visits), pulpal and periapical conditions (41 percent), gingival (15 percent) and periodontal diseases (five percent), and mouth abscess/cellulitis (three percent). Forty-two percent were covered by Medicaid, and 32 percent were uninsured. Mean charge per visit was $564, and total ED charge across the United States (US) was $104.2 million. Among those hospitalized following ED visits, total hospitalization charge across US was $162 million. Conclusions: A substantial amount of hospital resources are spent treating dental conditions in the ED. A total of 43 percent of ED visits were covered by Medicaid, and 32 percent were uninsured.