Hospital emergency department visits for non-traumatic oral health conditions among Rhode Island adults age 21-64 years, 2006-2010.

aCCordINg to data from the Behavioral riSk FacTor Surveillance System (BRFSS), a statewide health behavior survey, in 2008 and 2010, more than a quarter of Rhode Island adults aged 21–64 years are estimated to be without any dental insurance coverage (26.7%, 95% confidence interval=25.2%–28.3%). Adults with limited or no dental insurance coverage are more likely to avoid routine dental care, delay dental care as symptoms emerge, and rely on hospital emergency departments (EDs) to treat acute and urgent oral/dental problems. 2008 and 2010 BRFSS data also indicate that 22% of Rhode Island adults aged 21–64 years reported that they did not obtain preventive dental care (such as dental cleaning) in the past year, and more than half of these adults did not have dental insurance. Even among individuals who have dental insurance, scope of coverage and accessibility to dental care are variable. Rhode Island adults enrolled in Medicaid are eligible for a very limited scope of dental services, and are significantly less likely than those with private insurance to receive preventive dental care (Figure 1). EDs serve as dental safety net points of access for a significant number of low income and uninsured Rhode Island individuals and families who have limited access to oral health care due to lack of dental insurance, immigration status, or a number of other reasons. However, most non-traumatic and non-urgent dental care needs are more adequately and less expensively addressed and treated in primary outpatient dental offices or clinics. Reliance on the ED for less severe, or non-emergent oral/dental conditions results in significant health care spending and increased pressure on the already crowded and overburdened EDs throughout the State. The objectives of this report are to: (a) document the extent of Rhode Island adults’ hospital ED visits for oral/dental conditions that are mostly preventable and treatable in primary dental settings; (b) assess ED visits by adults’ age, insurance status, and primary diagnosis; and (c) discuss how to assure optimal and regular dental care for all Rhode Island adults and decrease unnecessary hospital ED visits.