Association Between Socioeconomic Status and Emergency Department Use for Non-traumatic Dental Conditions

TL;DR

People with lower income and education are more likely to use the emergency department for dental issues that could be prevented with proper care.

Contribution

This study identifies a strong link between low socioeconomic status and increased preventable emergency department visits for non-traumatic dental conditions.

Findings

Lower income is strongly associated with higher ED visits for non-traumatic dental conditions.

Individuals in the lowest SES quartile were 1.3 percentage points more likely to visit the ED for dental issues compared to those in the highest quartile.

The study highlights the need for improved access to oral healthcare to reduce preventable ED visits.

Abstract

Among ED visits, presentation for a non-traumatic dental condition represents one of the most preventable, as 79% of these visits are considered avoidable. Our goal was to investigate the association between individual-level socioeconomic status (SES) and emergency department (ED) use for non-traumatic dental conditions.

In this retrospective, pooled cross-sectional analysis we used data from a database of administrative health claims for members of large commercial and Medicare Advantage health plans. The sample included adults (≥ 18) who presented to the ED between 2017–2021 and had complete data on SES indicators (ie, income, education level, net worth, homeownership, and low-income subsidy status). The primary outcome was ED use for non-traumatic dental conditions, identified via International Classification of Diseases diagnosis codes. We used multivariate logistic regression models with marginal effects to examine the relationship between SES and ED visits, adjusted for demographics, geographic region, and disease burden.

Among 3,894,785 individuals, 74,685 (1.9%) had an ED visit related to non-traumatic dental conditions. Lower SES was significantly associated with increased ED visits for these conditions, with income exhibiting the strongest effect. Compared to individuals earning > $100,000 annually, those earning < $40,000 were 0.7 percentage points (1.5% vs 2.2%) more likely to visit the ED for non-traumatic dental conditions (P < .001). A dose-dependent effect was observed for the composite SES score, with individuals in the lowest SES quartile 1.3 percentage points (1.3% vs 2.6%) more likely to visit the ED compared to the highest quartile (P < .001).

Lower socioeconomic status is associated with higher ED use for non-traumatic dental conditions, underscoring disparities in oral healthcare access. Targeted policy interventions and better integration of oral and medical healthcare systems are needed to reduce preventable ED visits.