The Journal of the American Dental Association
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J Am Dent Assoc, Vol 139, No 9, 1205-1216.
© 2008 American Dental Association
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RESEARCH

Toothache Pain

A Comparison of Visits to Physicians, Emergency Departments and Dentists



Leonard A. Cohen, DDS, MPH, MS, Arthur J. Bonito, PhD, Donald R. Akin, MS, Richard J. Manski, DDS, PhD, MBA, Mark D. Macek, DDS, DrPH, Robert R. Edwards, PhD and Llewellyn J. Cornelius, PhD

Background. Researchers’ understanding of the use of emergency departments (EDs) and physicians’ offices for the treatment of toothaches is limited. The authors conducted a study to explore their use by low-income and minority adults in comparison with the use of traditional dental services.

Methods. Participants included low-income white, African-American and Hispanic adults who had experienced a toothache during the previous 12 months. A stratified random sample of 4,200 households in Maryland participated in a cross-sectional telephone survey. Trained survey staff completed interviews with someone in 272 (68.3 percent) of 398 eligible households.

Results. Only 8.7 percent of respondents contacted an ED for toothache pain relief, while 20.1 percent contacted physicians. The majority of respondents who contacted an ED (80.5 percent) or a physician (82.6 percent) also contacted a dentist. Contacts with a dentist were reported by 58.6 percent of respondents. The authors conducted tabular analyses using {chi}2 tests of statistical significance (P < .05) and SUDAAN’s multivariable logistic regression procedure (Research Triangle Institute, Research Triangle Park, N.C.) (P < .05).

Conclusions. Respondents experiencing toothache pain ultimately sought definitive resolution of their pain from dentists while visiting EDs and physicians for temporary relief. Access to dentists’ services was particularly problematic for Hispanics and was exacerbated by health literacy issues.

Clinical Implications. The elimination of oral health disparities must involve consideration of cultural influences on minority populations, as well as the responsibilities of the dental profession.

Key Words: Toothache pain; emergency departments; physicians’ offices; dentists’ offices; race/ethnicity

Abbreviations: EDs: Emergency departments.






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