Characteristics of patients with oral problems in Ontario Emergency Departments

Introduction: Publicly financed urgent dental care clinics have been proposed by professional and social welfare groups in order to meet the needs of socially marginalized groups. It is believed that such clinics can promote a reduction in hospital emergency department (ED) visits for dental problems. Objectives: This study examined dental-related visits to Ontario EDs from 2003/4 to 2005/6 to describe the public health need for these services. Methods: Data were obtained from the Canadian Institute for Health Information's (CIHI) National Ambulatory Care Reporting System (NACRS), an administrative data system that collects information on all ED visits in Ontario. Dental-related ED visits were identified by selecting NACRS records that had a main problem with ICD-10-CA codes in the range K00 – K14, representing diseases of the oral cavity, salivary glands and jaws. Results: A total of 140,778 visits were included. The number of visits increased steadily across the study period, from 42,665 in 2003/4 to 49,697 in 2005/6; a 16.5% increase. The majority of visits (i.e., 78%) were classified as non-urgent (Canadian Emergency Department Triage and Acuity Scale (CTAS) Level IV and V). By age group, 54.4% of visits were among those aged 20 to 44 years, while 21.4%, 17.3% and 6.9% of visits were among those aged 45 to 64, less than 20 and 65 years or older, respectively. The top three main problems associated with these visits included, periapical abscess without sinus involvement (30.1%), toothache (25.9%) and dental caries (5.5%). Conclusion: These findings provide evidence for the proposed need for public investments in dental care in order to provide access to all. (Supported: CDHSRU, OMOHLTC)