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Purpose: To characterize a child population seeking emergency dental care at the largest urban children’s hospital’s dental clinic and determine social determinants of health associated with emergency care seeking behaviors. Methods: 418 parents of children seeking emergency dental care at the Nationwide Children’s Hospital Dental Clinic (NCHDC) completed a two-part survey. Part 1 asked 22 questions regarding patient and parent demographics, social risk factors, prior utilization of the dental and medical health care system, parent-identified chief complaint, thorough pain history, and past dental history. In part 2, dentists noted diagnosis, whether patient had sought care elsewhere for chief complaint, and information regarding necessary treatment and follow-up care. Additional patient demographics, in depth medical history and information related to previous care seeking behaviors were drawn from the electronic health record.Results: Of 418 patients completing the survey, most respondents were Caucasian 227(54%) or African American 161(39%), with the majority residing in Franklin County 288(71%). At assessment, 243(59%) of patients presented with caries pain, and 74(18%) presented with dental trauma. 237(57%) patients required treatment, with extraction being the most common. 234(56%) of patients were in pain, and nearly half (49%) had been in pain for 7 days or more. Almost half of patients (44%) had a dental visit within the last 6 months, and nearly one third of patients (30%) were seen elsewhere before presenting to NCHDC for this emergency visit. 226(54%) patients have only ever sought care at NCHDC on an emergency basis, with 47(11%) having their first dental visit at the time of emergency visit. 301(77%) families were considered low income, earning less than $40,000 annually which is approximately 200% of the federal poverty level. 227(67%) children lived in single parent homes, and only 90(22%) parents reported having a bachelor’s degree. Only 259(63%) of respondents were employed, and the majority of patients (79%) had Medicaid insurance.Conclusions: Parents of children with dental pain often delay seeking care which results in patients presenting with progressive dental disease that frequently necessitates irreversible treatment, such as dental extractions. Low income, low education, minority status, public insurance and single parent home are risk factors associated with emergency dental care seeking behaviors and poor oral health outcomes requiring emergent dental treatment. |
