Findings from CareQuest Institute for Oral Health Provide New Insights into Managed Care (Repeated Use of Emergency Departments for Nontraumatic Dental Conditions: Factors Associated With Being a Superutilizer): Managed Care

2026 APR 24 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Fresh data on Managed Care are presented in a new report. According to news reporting originating in Boston, United States, by NewsRx journalists, research stated, “Due to inadequate access to regular, affordable dental care, many patients turn to emergency departments (EDs) for the treatment of nontraumatic dental conditions (NTDCs). NTDC ED visits are a large burden on the U.S. healthcare system, with over 1.3 million visits each year and over $1 billion in associated charges.”

The news reporters obtained a quote from the research from CareQuest Institute for Oral Health, “This study examines the characteristics of ED visitors and superutilizers (4+ ED visits in a calendar year) for non-dental (general) and dental reasons; investigates the cost of care for ED visitors and superutilizers; and estimates associations between patient characteristics and the likelihood of superutilization. Data obtained from the State Emergency Department Databases was used to summarise trends in visits by general and dental ED visitors and superutilizers, including visit rates and costs, across 14 states and 5 years. Logistic regression models were developed to estimate the likelihood of being dental superutilizers and superutilizers (for dental and non-dental visits) based on the characteristics of their first ED visit (age, gender, race/ethnicity, income quartile, insurance type, presence of comorbidities and state in which ED visit occurred). Of the total number of ED visitors (N = 25 905 031), the majority (92.4%) were general (non-dental) visitors; 6.4% were general superutilizers; 1.2% were dental visitors; and less than 1% (n = 2617) were dental superutilizers; dental superutilizers made up 0.2% of all superutilizers. Individuals who sought ED care for dental or non-dental reasons four or more times in a year were more likely to be white, be in the second or third quartile in terms of income, and have insurance coverage through Medicaid, other dental insurance, or to be uninsured. Finally, mean and median treatment costs for general and dental superutilizers were considerably higher than for both general and dental visitors to the ED. Individuals seeking ED care for NTDCs four or more times in a year are more likely to be white, have insurance coverage through Medicaid, Medicare or to be uninsured, and have one or more medical comorbidities. Cost of care for superutilizers is also considerably higher than for other ED visitors.”

According to the news reporters, the research concluded: “Expansion of dental services for adults, particularly those on Medicaid, is needed to ensure they can access timely preventative and restorative services and avoid the burden of dental crisis requiring a visit to the ED.”

This research has been peer-reviewed.

For more information on this research see: Repeated Use of Emergency Departments for Nontraumatic Dental Conditions: Factors Associated With Being a Superutilizer. Community Dentistry and Oral Epidemiology, 2026. Community Dentistry and Oral Epidemiology can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - http://www.wiley.com/; Community Dentistry and Oral Epidemiology - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-0528)

Our news correspondents report that additional information may be obtained by contacting Lisa J. Heaton, CareQuest Institute for Oral Health, Boston, United States. Additional authors for this research include Morgan Santoro, Adrianna C. Sonnek, Rebecca A. Preston, John J. O’Malley and Eric P. Tranby.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1111/cdoe.70060. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

The publisher of the journal Community Dentistry and Oral Epidemiology can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA.

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