title: Dental visits to a North Carolina emergency department: a painful problem.
abstract: BACKGROUND
  Emergency departments (EDs) act as the safety net and alternative care site for patients without insurance who have dental pain.
  
  
  METHODS
  We conducted a retrospective chart review of visits to an urban teaching hospital ED over a 12-month period, looking at patients who presented with a chief complaint or ICD code indicating dental pain, toothache, or dental abscess.
  
  
  RESULTS
  The number of visits to this ED by patients with a dental complaint was 1,013, representing approximately 1.3% of all visits to this ED. Dental patients had a mean age of 32 (+/- 13) years, and 60% of all dental visits were made by African Americans. Dental patients were more likely to be self-pay than all other ED patients (61% versus 22%, P < 0.001). At the vast majority of dental ED visits (97%), the patient was treated and discharged; at most visits (90%) no dental procedure was performed. ED treatment typically consisted of pain control and antibiotics; at 81% of visits, the patient received an opiate prescription on discharge, and at 69% of visits, the patient received an antibiotic prescription on discharge.
  
  
  CONCLUSIONS
  This retrospective chart review covered a limited period of time, included only patients at a large urban academic medical center, and did not incorporate follow-up analysis.
  
  
  CONCLUSIONS
  Although they make up a small percentage of all ED visits, dental ED visits are more common among the uninsured, seldom result in definitive care or hospital admission, and often result in prescription of an opioid or antibiotic. These findings are cause for concern and have implications for public policy.
authors.affiliation: Department of Surgery, Duke University Medical Center #3096, 2301 Erwin Rd, Durham, NC 27710, USA. michael.hocker@duke.edu
authors.forename: Michael B
authors.initials: MB
authors.lastname: Hocker
authors.forename: John J
authors.initials: JJ
authors.lastname: Villani
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Borawski
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Evans
authors.forename: Scott M
authors.initials: SM
authors.lastname: Nelson
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Gerardo
authors.forename: Alex T
authors.initials: AT
authors.lastname: Limkakeng
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003729:Dental Care / Q000458:organization & administration*; D003752:Dental Health Services / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D008484:Medicaid / Q000458:organization & administration; D008875:Middle Aged; D009657:North Carolina; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult