scholarly journals Emergency and Urgent Dental Visits Among Medicaid Enrollees from 2013 to 2017

2020 ◽  
Author(s):  
Rebekah Fiehn ◽  
Ilya Okunev ◽  
Mary Bayham ◽  
Steven Barefoot ◽  
Eric P Tranby
Keyword(s):  
Dental Treatment ◽  
Definitive Treatment ◽  
Emergency Visit ◽  
Dental Visits ◽  
Dental Procedures ◽  
Nationally Representative ◽  
Ibm Watson ◽  
Dental Emergency ◽  
Dental Providers ◽  
Medical Claims Database

Abstract Background: Efforts to combat the spread of COVID-19 have led to guidance to restrict dental practice to treating emergency and urgent dental visits and reduce or eliminate elective dental procedures. Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs.Methods: Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states.Result: Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, with the majority returning within 30 days for that treatment.Conclusions: The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.

scholarly journals Emergency and Urgent Dental Visits among Medicaid Enrollees from 2013 to 2017

2020 ◽  
Author(s):  
Rebekah Fiehn ◽  
Ilya Okunev ◽  
Mary Bayham ◽  
Steven Barefoot ◽  
Eric Tranby
Keyword(s):  
Dental Treatment ◽  
The United States ◽  
Definitive Treatment ◽  
Dental Visits ◽  
Dental Procedures ◽  
Nationally Representative ◽  
Ibm Watson ◽  
Dental Emergency ◽  
Dental Providers ◽  
Medical Claims Database

Abstract Background: Efforts to combat the spread of COVID-19 have led to guidance to restrict dental practice to treating emergency and urgent dental visits and reduce or eliminate elective dental procedures. Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs.Methods: Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states in the United States. Result: Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days. Conclusions: The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.

scholarly journals Emergency and urgent dental visits among Medicaid enrollees from 2013 to 2017

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rebekah Fiehn ◽  
Ilya Okunev ◽  
Mary Bayham ◽  
Steven Barefoot ◽  
Eric P. Tranby
Keyword(s):  
Dental Treatment ◽  
The United States ◽  
Definitive Treatment ◽  
Dental Visits ◽  
Appropriate Care ◽  
Nationally Representative ◽  
Ibm Watson ◽  
Dental Emergency ◽  
Dental Providers ◽  
Medical Claims Database

Abstract Background Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs. Methods Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states in the United States. Result Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days. Conclusions The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.

scholarly journals Emergency and Urgent Dental Visits among Medicaid Enrollees from 2013 to 2017

2020 ◽  
Author(s):  
Rebekah Fiehn ◽  
Ilya Okunev ◽  
Mary Bayham ◽  
Steven Barefoot ◽  
Eric Tranby
Keyword(s):  
Dental Treatment ◽  
The United States ◽  
Definitive Treatment ◽  
Care Provision ◽  
Dental Visits ◽  
Nationally Representative ◽  
Ibm Watson ◽  
Dental Emergency ◽  
Dental Providers ◽  
Medical Claims Database

Abstract Background: Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs.Methods: Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states in the United States. Result: Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days. Conclusions: The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.Keywords: Emergency Dental, COVID-19, Teledental, Medicaid

scholarly journals “Dental Cluster” Versus “Metabolic Cluster”: Analyzing the Associations of Planned and Delivered Dental Procedures with Metabolic Syndrome, Utilizing Data from the Dental, Oral, Medical Epidemiological (DOME) Cross-Sectional Record-Based Nationwide Study

Biology ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 608
Author(s):  
Itzhak Abramovitz ◽  
Avraham Zini ◽  
Pablo Pribluda ◽  
Ron Kedem ◽  
Dorit Zur ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Multivariate Analysis ◽  
Dental Treatment ◽  
Cross Sectional Study ◽  
Treatment Needs ◽  
Cross Sectional ◽  
Vein Thrombosis ◽  
Dental Procedures ◽  
Obstructive Sleep ◽  
Nationally Representative

There are conflicting results existing regarding the association between dental status and metabolic syndrome (MetS). The present research analyzed the associations of the sum of the standard dental unit (SDU) scores of planned (SDU-P) and delivered (SDU-D) dental procedures per patient with MetS components, consequences, and related conditions. The SDU score of each dental procedure represents the time and complexity of the executed procedure. This cross-sectional study analyzed data from the Dental, Oral, Medical Epidemiological (DOME) repository, which includes comprehensive socio-demographic, medical, and dental databases of a nationally representative sample of 132,529 military personnel. Univariate analyses revealed that SDU-P had statistically significant positive associations with all systemic morbidities related to MetS, while the SDU-D exhibited positive associations with some of the systemic morbidities and with lower ORs. SDU-P and SDU-D were associated with worse scores of auxiliary examinations used in the assessment of MetS components. SDU-P retained significant positive associations in the multivariate analysis with impaired glucose tolerance (IGT) (OR = 7.40 (1.91–28.57)), deep vein thrombosis (DVT) (OR = 5.61 (1.53–20.83)), obstructive sleep apnea (OSA) (OR = 5.05 (2.40–10.63)), and fatty liver (OR = 1.82 (1.17–2.84)). In contrast, obesity was the only systemic parameter retaining a significant association with SDU-D following multivariate analysis (OR = 1.47 (1.23–1.76)). It can be concluded that SDU-P, but not SDU-D, is a better predictor of systemic morbidities related to MetS. In other words, MetS is associated with a higher dental treatment needs burden, rather than with dental treatments performed de facto. Dental and general health authorities should collaborate and share information and focus on reducing common health-related risk factors, such as smoking and sugar consumption, in particular among high-risk populations, such as immigrants and those with lower SES and rural locality.

Outcomes of dental procedures performed on children under general anesthesia

2004 ◽  
Vol 27 (2) ◽  
pp. 181-183 ◽  
Author(s):  
Ali Al-Eheideb ◽  
Neal Herman
Keyword(s):  
General Anesthesia ◽  
Dental Treatment ◽  
Positive Outcome ◽  
High Rate ◽  
Definitive Treatment ◽  
Class Iii ◽  
Posterior Teeth ◽  
Composite Restorations ◽  
Anterior Teeth ◽  
Dental Procedures

The purpose of this study was to evaluate the integrity and longevity of restorative and pulpal procedures performed on primary teeth under general anesthesia (GA). Fifty-four children, who received comprehensive dental treatment under general anesthesia between 1993 and 1995, were included. The postoperative examination period ranged from 6 to 27 months. Children were examined and the quality of the restorations were recorded and evaluated. Behavior problems and inability to cooperate were the main reasons for treatment under GA. Results showed that restoration of posterior teeth with stainless steel crowns (SSC) were more successful (95.5%) when compared to amalgam or composite restorations (50%). In the anterior teeth, strip crowns had a success rate similar to that of Class III, IV and V composite resin materials. Pulpotomies showed an extremely high rate of success (97.1%), while sealants were retained 68.3% of the time. In conclusion, SSC are more likely to be successful and last longer than multisurface amalgam or composite restorations in children treated under general anesthesia. Definitive treatment is more likely to ensure a more positive outcome for children treated under general anesthesia due to less frequent complications from failed restorations or pulpal procedures.

scholarly journals Anesthetic Management of the Pregnant Patient: Part 1

2021 ◽  
Vol 68 (1) ◽  
pp. 52-62
Author(s):  
Jaimin Shin
Keyword(s):  
Dental Treatment ◽  
Anesthetic Management ◽  
Pregnant Patient ◽  
Developed Countries ◽  
Anesthetic Agents ◽  
Dental Procedures ◽  
Dental Patient ◽  
The Many ◽  
Dental Providers ◽  
The Impact

As delays in the age for a mother's first pregnancy continue to trend upward globally, particularly in developed countries, many pregnant patients are increasingly educated on the importance of obtaining dental care throughout their pregnancies. Guidelines set forth by the American Dental Association and the American College of Obstetrics and Gynecologists highlight the importance of dental treatment for optimizing maternal-fetal health across all trimesters, especially for emergent dental issues. The pregnant dental patient undergoes significant physiologic remodeling unique to each trimester, which may complicate treatment. Providing safe anxiety and pain control for dentistry can be further complicated if sedation or general anesthesia is required for the parturient. This is even more true when superimposed with increasingly prevalent underlying comorbidities like hypertension and diabetes. As dental providers, there is a clear need for continuing education on the many challenges associated with caring for pregnant patients due to this being an often overlooked subject in undergraduate and postgraduate dental education. Part 1 of this review will present the maternal and fetal physiologic considerations and the impact on patient management from an anesthetic perspective. Additional discussion focusing on common sedative and anesthetic agents used during dental procedures and their considerations will follow in Part 2.

scholarly journals Case Report: Iatrogenic Dental Progress of Phantom Bite Syndrome: Rare Cases With the Comorbidity of Psychosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Motoko Watanabe ◽  
Chaoli Hong ◽  
Zhenyan Liu ◽  
Chihiro Takao ◽  
Takayuki Suga ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Orthodontic Treatment ◽  
Dental Treatment ◽  
Psychiatric Treatment ◽  
Dental Occlusion ◽  
Body Parts ◽  
Case Presentation ◽  
Dental Visits ◽  
Dental Procedures ◽  
History Of

Introduction: Phantom bite syndrome (PBS) is considered as the preoccupation with dental occlusion and the continual inability to adapt to changed occlusion. These patients constantly demand occlusal corrections and undergo extensive and excessive dental treatments. We present three cases with PBS-suspected iatrogenic concerns and the attribution to underlying psychosis.Case Presentation: A 70-year-old female demanded orthodontic retreatment and complained of tightness and cramped sensation of teeth in the oral cavity, uncomfortable occlusion, and pain in her neck and legs that she was convinced was induced by orthodontic treatment. However, even earlier than the orthodontic treatment, she had kept doctor shopping for over 35 years, not merely dentists but also psychiatrists, neurologists, and so on; she was diagnosed with bipolar disorder. A 48-year-old female complained of malaligned improper occlusion and demanded occlusal adjustment. These symptoms occurred in the absence of a dental trigger and were worsened by orthodontic treatment. She underwent psychiatric treatment for 15 years with a diagnosis of bipolar disorder. A 38-year-old female, who had a history of schizophrenia for over 20 years, complained of occlusal discomfort and revisited with a complaint of abnormal occlusion due to excessive dental procedures. In the last two cases, requests for dental procedures had reduced owing to the collaboration between the psychiatrists and dentists. All the cases first visited our clinic following a succession of dental visits. They were strongly convinced that occlusal correction was the only solution to their symptoms, including the symptoms of discomfort in other body parts. Their misleading perceptions were uncorrectable, and repeated dental treatments exacerbated their complaints. Moreover, the dentists overlooked the psychotic histories of the patients, while the comorbid psychosis resulted in a strict demand for dental treatment by the patients.Conclusions: The presented PBS cases with psychosis suggest that repeated dental treatments and comorbid psychosis exacerbate PBS. Moreover, their persistent demands reflecting comorbid psychosis led dentists to perform numerous procedures. Early detection of underlying psychosis and the prompt collaboration between psychiatrists and dentists are integral to help prevent complications in PBS cases with psychosis.

Restorative dental treatment in times of COVID-19

2020 ◽  
Vol 68 ◽  
Author(s):  
Robson de Lima GOMES ◽  
Marlus da Silva PEDROSA ◽  
Claudio Heliomar Vicente da SILVA
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Dental Treatment ◽  
Close Contact ◽  
Cross Contamination ◽  
Clinical Protocols ◽  
Know How ◽  
Dental Procedures ◽  
Dental Staff ◽  
Dental Professional ◽  
Restrictive Measures

ABSTRACT Since the outbreak of the Coronavirus Disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), numerous restrictive measures have been adopted by governments of different countries. The return to elective dental care in Brazil is a reality even during the COVID-19 pandemic. During restorative dental procedures, the dental professional requires close contact with the patient, being exposed to contaminated saliva and fluids. In addition, transmission of COVID-19 by the generation of aerosol produced by dental handipieces may be possible. Thus, the dental staff must know how to act during restorative dental procedures, putting into practice the correct clinical protocols to avoid cross-contamination and COVID-19 spread. The purpose of this article is to review the literature on the biosafety practices especially in the context of restorative dental procedures in times of COVID-19.

scholarly journals Evaluation of the Most Stressful Dental Treatment Procedures of Conservative Dentistry among Polish Dental Students

2021 ◽  
Vol 18 (9) ◽  
pp. 4448
Author(s):  
Katarzyna Mocny-Pachońska ◽  
Rafał J. Doniec ◽  
Sylwia Wójcik ◽  
Szymon Sieciński ◽  
Natalia J. Piaseczna ◽  
...  
Keyword(s):  
Dental Treatment ◽  
High Stress ◽  
Dental Students ◽  
Endodontic Treatment ◽  
Stressful Environment ◽  
Caries Treatment ◽  
Dental Procedures ◽  
Conservative Dentistry ◽  
High Level ◽  
Treatment Procedures

Background: Dental schools are considered to be a very stressful environment; the stress levels of dental students are higher than those of the general population. The aim of this study was to assess the level of stress among dental students while performing specific dental procedures. Methods: A survey was conducted among 257 participants. We used an original questionnaire, which consisted of 14 questions assigned to three categories: I—Diagnosis, II—Caries Treatment, and III—Endodontic Treatment. Each participant marked their perceived level of stress during the performed dental treatment procedures. The scale included values of 0–6, where 0 indicates no stress, while 6 indicates high stress. Results: Third- (p=0.006) and fourth-year (p=0.009) women were characterized by a higher level of perceived stress during dental procedures related to caries treatment. Caries treatment procedures were the most stressful for 18.3% of third-year students, 4.3% of fourth-year students, and 3.2% of fifth-year students. Furthermore, 63.4% of third-year students, 47.3% of fourth-year students, and 17.2% of fifth-year students indicated that they felt a high level of stress when performing endodontic procedures. Conclusion: Third- and fourth-year female students are characterized by a higher level of stress during caries and endodontic treatment procedures. The most stressful treatments for participants were endodontic treatment procedures.

scholarly journals 967. Concordance of Antibiotic Prescribing with the Proposed American Dental Association Acute Oral Infection Guidelines within Veterans Affairs (VA) Dentistry

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S31-S32
Author(s):  
Daniel Carlsen ◽  
Katie J Suda ◽  
Ursula C Patel ◽  
Gretchen Gibson ◽  
Marianne M Jurasic ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Apical Periodontitis ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Oral Infections ◽  
American Dental Association ◽  
Dental Procedures ◽  
Icd 10 ◽  
Future Work ◽  
Irreversible Pulpitis

Abstract Background US dentists prescribe 10% of outpatient antibiotics. However, assessing the appropriateness of dental antibiotic prescribing has been challenging due to a lack of guidelines for common infections. In 2019, the American Dental Association proposed clinical practice guidelines (CPG) on the management of common acute oral infections for the first time. Our objective was to describe national baseline antibiotic prescribing for the treatment of irreversible pulpitis, apical periodontitis, and acute apical abscess prior to the release of the proposed CPG. Methods We performed a cross-sectional analysis of national VA data from January 1, 2017 to December 31, 2017. We identified cases of irreversible pulpitis, apical periodontitis, and acute apical abscess using ICD-10-CM codes. Patient demographics, facility location, medical conditions, dental procedure codes (“CDTs”), and diagnostic (ICD-10-CM) codes were extracted from the VA Corporate Data Warehouse. Antibiotics prescribed by a dentist within 7 days of a visit were included. Multivariable logistic regression identified variables associated with antibiotic prescribing for each infection. Results Of the 470,039 VA dental visits with oral infections coded, 25% of irreversible pulpitis, 41% of apical periodontitis, and 61% of acute apical abscess visits received antibiotics. Amoxicillin was prescribed most frequently. Although the median days’ supply was 7 days, prolonged use of antibiotics was frequent (9.2% of irreversible pulpitis, 17.8% of apical periodontitis, 28.7% of acute apical abscess received antibiotics for ≥8 days). Of the irreversible pulpitis visits with antibiotics prescribed, 20.0% received ≥2 antibiotics. Patients with high-risk cardiac conditions, prosthetic joints, and certain dental procedures were associated with receipt of antibiotics (table). Conclusion Prior to the release of the ADA guidelines, 75.8% and 59.4% of irreversible pulpitis and apical periodontitis were concordant with proposed recommendations. These data identify opportunities to improve prescribing and serve as a benchmark for future outpatient antimicrobial stewardship efforts. Future work should assess definitive dental treatment and populations without access to oral health care. Disclosures All Authors: No reported Disclosures.

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