Periodontal disease pushes thousands to the ER

Jan 3, 2011

Individuals with acute and aggressive periodontitis are more likely to visit hospital emergency departments (EDs) than those without, costing U.S. hospitals millions of dollars in the process, according to a study in the Journal of Periodontology (December 7, 2010).

While the chances of presenting to hospital EDs are significantly higher in individuals ignoring regular dental care and in those with medical conditions, little is known about estimates of hospital-based ED visits due to periodontal conditions, noted researchers from Harvard School of Dental Medicine and the University of Iowa.

They used the Healthcare Cost and Utilization Project's Nationwide ED Sample for 2006 to determine the incidence of ED visits that occurred due to periodontal conditions and to identify the risk factors for hospitalizations during those visits. Patients that visited the ED with a primary diagnosis of acute gingivitis, chronic gingivitis, gingival recession, aggressive or acute periodontitis, chronic periodontitis, periodontosis, accretions, other specified periodontal disease, or unspecified gingival and periodontal disease were selected for the study.

The researchers found that 85,039 visits to hospital EDs in 2006 were primarily attributed to gingival and periodontal conditions. These visits were made with a mean charge per visit of $456.31 and total charges topping $33 million. About 36% and 33% of all visits occurred among the lowest income group and uninsured population, respectively.

The total ED charges for those covered by Medicare, Medicaid, private insurance, and other insurance plans were $4.9 million, $9.1 million, $8 million, and $0.92 million, respectively. The uninsured were charged a total of $10.06 million, and the total hospitalization charge for this group was $17.51 million.

Patients with comorbid conditions (congestive heart failure, valvular disease, hypertension, paralysis, neurological disorders, chronic pulmonary disease, hypothyroidism, liver disease, AIDS, coagulopathy, deficiency anemia, obesity, alcohol abuse, or drug abuse) were associated with a higher risk of hospitalization during an ED visit for periodontal conditions compared with those without (p < 0.05). Patients who had a primary diagnosis of acute or aggressive periodontitis were associated with significantly higher odds of being hospitalized during ED visits.