Oral Health

National and state surveillance systems for oral health have relied on sample-based screenings and self-reported surveys.1 Recent publications suggest the need and potential for use of data from syndromic surveillance systems and insurers to monitor indicators of oral health status, utilization of care, and costs of treatment.2,3 Few consensus indicators for oral health derived from these data sources exist, with the exception of a set of five ICD-9 codes comprising ambulatory care sensitive dental problems (ACS-DP).4 This paper describes North Carolina’s Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) data analyzed within CDC’s BioSense System to report state and county population-based rates of hospital emergency department (ED) utilization for ACS dental conditions.

Objective

This paper describes use of national and state syndromic surveillance systems for monitoring and evaluating usage of hospital emergency departments for ambulatory care sensitive dental problems.

Using the chief complaint field from our established syndromic ED system, we developed definitions for potentially preventable oral health visits (OHV) and examined patterns in 2009-2011 data. Under the widest definition, OHV comprised about 1% of ED visits. Adults ages 18 to 29 had markedly higher OHV than other ages, as did certain neighborhoods/EDs. We found more than half of OHV occurred during daytime hours, suggesting opportunities for targeted outreach and education. With some caveats, syndromic ED data provide a useful complement to other oral health surveillance strategies.

Objective

To utilize an established syndromic reporting system for surveil- lance of potentially preventable emergency department (ED) oral health visits (OHV) in New York City (NYC).

Concern over oral health-related ED visits stems from the increasing number of unemployed and uninsured, the cost burden of these visits, and the unavailability of indicated dental care in EDs [1]. Of particular interest to NC state public health planners are Medicaid-covered visits. Syndromic data in biosurveillance systems offer a means to quantify these visits overall and by county and age group.

Objective

The objective was to use syndromic surveillance data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool NCDETECT and from BioSense to quantify the burden on North Carolina (NC) emergency departments of oral health-related visits more appropriate for care in a dental office (ED). Calculations were sought in terms of the Medicaid-covered visit rate relative to the Medicaid-eligible population by age group and by county.

Lack of access to regular dental care often results in costly, oral health visits to EDs that could otherwise have been prevented or managed by a dentist (1). Most studies on oral health-related visits to EDs have used a wide range of classifications from different databases, but none have used syndromic surveillance data. The volume, frequency, and included details of syndromic data enabled timely burden estimates of nontraumatic oral health visits for NC EDs.

Objective:

To develop a nontraumatic oral health classification that could estimate the burden of oral health-related visits in North Carolina (NC) Emergency Departments (EDs) using syndromic surveillance system data.