194 - Risk Factors of Dental Trauma in a Hospital Emergency Department

Purpose: There is currently limited research on the risk factors that contribute to a caregiver’s decision to seek dental treatment in a hospital emergency department (ED) rather than in a dental office. Known public health risk factors that may limit access to outpatient dental care include age, gender, ethnicity, lack of dental home, and payer status. The purpose of this prospective study is to assess and identify the demographics and risk factors of patients who present with dental trauma to a Level 1, urban pediatric emergency department.

Methods: This prospective study evaluated existing medical records and collected data points from pediatric dental resident encounters at the Cincinnati Children’s Hospital Medical Center (CCHMC) ED from January 1 2023 to December 31 2023. Specific data points included age, gender, ethnicity, day of week, month of year, referral source, payer status, dental home status, zip code, dental injury diagnosis and treatment rendered, sedation utilization, and length of stay (LOS) in the emergency department. Descriptive statistics were used to analyze results.

Results: In 2023, the pediatric dental residents at CCHMC treated 187 patients in the emergency department. The average time spent in the ED for each encounter was 311.48 minutes. 58.8% of the patients treated in the ED participated with Medicaid or Medicaid with a supplemental private insurance. 84.6% of the African American patients treated in the ED participated with Medicaid insurance (p = <0.001). 71.5% of patients who self reported to the ED had an existing dental home (p = 0.001). The average age of those without a dental home was 5.94.

Conclusion: The majority of children who reported to the CCHMC ED for dental trauma had an existing dental home, including by self-referral and their community dentist. The average time spent in the ED for dental trauma was over 5 hours, irrespective of dental trauma type, treatment rendered or use of sedation. The patients treated in the CCHMC ED were predominantly supported by state insurance. A disproportionate number of minority patients treated in the ED for dental trauma participated with Medicaid insurance. Understanding the risk factors identified in this study can inform healthcare providers of the barriers to obtaining emergent dental care in a private office versus the emergency department.