Hospital Emergency Department Visits by Ambulance for Tooth Pain

Objectives: Information on the use of an ambulance to convey patients complaining of tooth pain (TP) to emergency departments is scanty in the United States. The purpose of this study was to examine the prevalence of ambulance use for TP visits to emergency departments (ED) and factors associated with such visits.

Methods: Data from the National Hospital Ambulatory Medical Care survey (NHAMCS) for 2003 to 2012 was analyzed to identify the estimated prevalence of ED visits for tooth pain, and among those visits, the number who were conveyed by ambulance. Descriptive statistics were obtained and multivariate logistic regression used to determine the odds of the associated factors in relation to the occurrence of ED visits via ambulance for TP. All analyses were adjusted for the survey design.
Results: Overall 1.2% of the total TP visits to the ED were by ambulance ranging from <1% in 2003 to a high of 3% in 2011. The proportion of TP visits by ambulance was highest among public insurance enrollees (2.1%), 45-65-year-old (3.1%) and Hispanic (2.5%) patients. In the multivariable analysis gender, day of the week, region, race/ethnicity and reason for visits were not significant predictors of TP visits to the ED by ambulance. Compared to 25-44 years old, those aged 45-64 years old were significantly more likely to visit the ED by ambulance due to TP. Payment type and race/ethnicity were the strongest predictors of TP visits to ED by ambulance.

Conclusions: While ED visits that utilize an ambulance for TP are relatively uncommon, they do occur with some frequency, and have cost implications to the healthcare system. Study results suggest that adults (45-64 years old) and public insurance enrollees had higher odds of the use of an ambulance for ED visits for TP.