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Comparison of patient visits to emergency departments, physician offices, and dental offices for dental problems and injuries


  • Grant number 5R01DE017685-02 from the National Institute of Dental and Craniofacial Research supported this research.

Dr. Leonard A. Cohen, Department of Health Promotion and Policy, University of Maryland Dental School, 650 West Baltimore Street, Baltimore, MD 21201. Tel.: 410-706-7289;
Fax: 410-706-7745; e-mail: Leonard A. Cohen, Richard J. Manski, and Mark D. Macek are with Department of Health Promotion and Policy, University of Maryland Dental School. Arthur J. Bonito and Celia Eicheldinger are with Health Services and Social Policy Research Division, Research Triangle Institute. Robert R. Edwards is with Department of Psychiatry, Johns Hopkins University School of Medicine. Niharika Khanna is with Department of Family and Community Medicine and the Greenebaum Cancer Center, University of Maryland School of Medicine.


Objectives: Our understanding of the use of emergency departments (EDs) and physician offices for the management of dental problems is limited. We undertook this study to examine whether there are differences in their use by low-income White and minority adults as compared with higher-income adults.

Methods: Participants included White, Black, and Hispanic adults who had experienced a dental problem during the previous 12 months and who visited a physician, ED, or dentist for treatment. We selected a stratified random sample of 27,002 Maryland households with listed telephones to screen for eligibility. We identified 1,387 households with an eligible adult, selected 423 for interviews, and completed interviews with 401 (94.8%).

Results: To restore correct proportionality to the sample, and to adjust for nonresponse and the distribution of demographic characteristics, weights were created for use in the analyses. Only 7.1 percent of respondents contacted an ED, while 14.3 percent contacted a physician and 90.2 percent a dentist. The vast majority of respondents who contacted an ED (96.0%) or a physician (92.2%) also contacted a dentist. Lower-income respondents were more likely to seek care from an ED, while higher-income respondents were more likely to seek care from a dentist. Overwhelmingly, respondents visiting EDs (89.4%) and physicians (51.7%) were instructed to see a dentist or given prescriptions/samples. Treatment provided by EDs, physicians, and dentists was not associated with the respondent's income or race/ethnicity.

Conclusions: Respondents visiting EDs and physicians typically did not receive definitive care and subsequently visited a dentist for treatment.