Emergency Department Use for Dental Problems among Homeless Individuals: A Population-Based Cohort Study

Abstract

Objectives-To evaluate emergency department (ED) visits for dental problems among Toronto's homeless population (Ontario, Canada).Methods-A random sample of 1,189 homeless was recruited from shelters and meal programs. Emergency department visits for non-traumatic dental problems (ICD-10-CA codes K00-K14) were identified using participants' health insurance number, during [2005][2006][2007][2008][2009]. Age-and sexmatched controls were selected from low-income neighborhoods.Results-Homeless and matched controls had 182 and 10 ED visits for dental problems, respectively. Homeless people were more significantly more likely (OR=2.27, p=.007) to make ED visit for dental problems compared with controls. Over 80% of the ED visits by homeless people were for odontogenic infections, and 46% of homeless people had more than one such visit. Conclusion-The high rate of ED visits for dental problems by people who are homeless suggests that access to dental care is inadequate. The large number of repeat visits indicates that ED settings are ineffective for treatment of dental problems.

Emergency department visits for dental problems associated with trauma in Alberta: A report between the years 2011 and 2017

“…14 Studies have shown that DPAT addressed within 24 hours will prevent poor prognosis and subsequent dentalrelated issues. 11 An important finding in the present study is that 4772 patients had two or more visits for DPAT. Expansion of dental public health services should be a viable cost-effective solution to address the dental needs of the population.…”

“…10 The availability of dental services without the barrier of affordability will facilitate access to dental professionals and possibly reduce the inappropriate utilization of EDs for dental problems. 11 An important finding in the present study is that 4772 patients had two or more visits for DPAT. The quantitative nature of this study does not provide qualitative findings on the repeated EDs visits.…”

“…With no dentists or dental staff, treatment for dental trauma is often beyond the scope of most ED's resources. 10,11 The aim of this study was to report on the prevalence of ED visits for dental problems associated with trauma (DPAT) in Alberta, Canada, during the period between 2011 and 2017. 8 In Canada, the Report on the Findings of the Oral Health Component of the Canadian Health Measures Survey 2007-2009 identified that, for the general population, the prevalence of dental trauma is on average 7% among children (6 to 11 years old), 16% among adolescents (12 to 19 years old), and 24% among adults (20 to 79 years old).…”

“…The level of dental care provided in EDs rarely involves more than symptomatic advice and pharmacotherapy. 10,11 The aim of this study was to report on the prevalence of ED visits for dental problems associated with trauma (DPAT) in Alberta, Canada, during the period between 2011 and 2017. This 7-year descriptive report had the specific objectives of providing up-to-date information regarding ED utilization for dental trauma concerning the demographics of users and distribution of ED visits across the Province of Alberta, allowing for an assessment of possible trends over the period of time observed.…”

Trends in emergency department visits for non-traumatic dental conditions in Ontario from 2006 to 2014

“…7 Yet, in Canada, most studies on ED visits for NTDC present data for only one or two years; 4,5 only one has presented trend data, but it was limited to homeless adults over a four-year period in one Ontario municipality. 3 Trend data are important, as they give researchers and policy-makers the ability to explore patterns in a given outcome, and allow for hypothesis formulation on potential environmental exposures and their effects on such trends. Further, though most studies on ED visits for NTDC in Canada quantify the burden, they do not report on the predictors of such visits either at the individual or area-based level.…”