Delineating factors surrounding emergency dental access behavior for nontraumatic dental conditions among patients with available access to local preventive dental care

Authors

• Ingrid Glurich, Marshfield Clinic Research Institute (MCRI), 1000 North Oak Avenue, Marshfield, Wisconsin, USA.
• Aloksagar Panny, Methodist Health System: Methodist Dallas Medical Center, 1441 North Beckley Avenue, Dallas, Texas, USA.
• Neel Shimpi, Marshfield Clinic Research Institute (MCRI), 1000 North Oak Avenue, Marshfield, Wisconsin, USA.
• Mary Dorsch, Family Health Center of Marshfield Inc. (FHC-M), 1307 N Street, Joseph Avenue, Marshfield, Wisconsin, USA.
• Arun Bhatta, University of Minnesota School of Dentistry, 515 Delaware Street SE, Minneapolis, Minnesota, USA.
• Richard Berg, Marshfield Clinic Research Institute (MCRI), 1000 North Oak Avenue, Marshfield, Wisconsin, USA.
• Amit Acharya, Advocate Health - MidwestFollow
• Gregory Nycz, Family Health Center of Marshfield Inc. (FHC-M), 1307 N Street, Joseph Avenue, Marshfield, Wisconsin, USA.

Recommended Citation

Glurich I, Panny A, Shimpi N, et al. Delineating Factors Surrounding Emergency Dental Access Behavior for Nontraumatic Dental Conditions Among Patients With Available Access to Local Preventive Dental Care. Int J Dent. 2026;2026:9509544. Published 2026 Jun 24. doi:10.1155/ijod/9509544

Abstract

Objectives: A case-control study examined factors contributing to emergency dental clinic access for nontraumatic dental conditions (ED-NTDC) among individuals residing within 20 miles of 10 networked dental clinics comprising a dental safety net.

Materials and methods: Phase I: using dental diagnostic codes for ED-NTDC visits and dental prophylaxis visits that occurred from January 1, 2019 through May 19, 2019, interrogation of an integrated medical-dental electronic health record (EHR) identified cases (n = 1784) and controls (n = 18,612), respectively, matched by dental center. Unadjusted odds ratios (ORs) with 95% confidence intervals (CIs) and chi-squared p-values were determined using unadjusted bivariate logistic regression analysis for each demographic variable by comparing subgroup-specific proportions of cases and controls to a designated reference subgroup. Phase II: survey tools were designed and targeted to Phase I cases (n = 84) and controls (n = 113). Applying descriptive statistics, variability identified between case and control survey question responses defined additional potential candidate variables contributing to risk for ED-NTDC visits.

Results: Statistically significant risk variables ORs were graphically depicted in a forest plot and included: age 18-35 (OR 1.4), 36-50 (OR 1.2), sex (male: OR 1.2), race (non-White: (OR 1.7)), payer status (self-pay: (OR 2.4); Medicaid: (OR 1.6), sliding fee: (OR 1.8)), and E-NTDC visits in medical (OR: 2.8) or dental (OR 2.0) settings in the prior 2 years. Twice-annual dental visit rates were higher among controls vs. cases. Cases vs. controls more frequently indicated: (1) a preference for pulling painful teeth; (2) dental visits were only necessary for dental emergencies; (3) delay in seeking dental care for emergent dental pain; (4) higher rates of dental fear. Economic factors, ("could not afford dental care" and "lack of insurance") especially in younger age tiers, strongly contributed to ED-NTDC visits.

Conclusions: Barriers to oral health access for vulnerable populations persist. Public health initiatives targeting dental health maintenance and literacy require expansion.

Document Type

Article

PubMed ID

42358329