Antibiotic and opioid prescribing for dental-related conditions in emergency departments
Open accessAbstract
Background Patients visiting the emergency department (ED) for nontraumatic dental conditions usually receive nondefinitive health care and are referred to treatment elsewhere. This may lead to potentially avoidable antibiotic and opioid use. Methods A retrospective study was conducted in IBM MarketScan Research Databases in Treatment Pathways from 2012 through 2014. This study included patients with commercial insurance or enrolled in Medicaid. Patients receiving a diagnosis of a dental condition in the ED with no secondary diagnosis warranting an antibiotic prescription were included. Patients were stratified on the basis of the primary payer and available demographics, as well as on the basis of repeat visits to the ED. Results A higher proportion of Medicaid beneficiaries (280,410, 4.9%) had dental-related visits compared with the commercially insured (159,066, 1.3%). The most common diagnoses were similar for both groups and included caries. In both cohorts, the 18- through 34-year age group had the highest rate of dental-related ED visits. Within 7 days of a dental-related ED visit, 54.9% of Medicaid beneficiaries and 55.0% of commercially insured beneficiaries filled a prescription for an antibiotic and 39.6% of Medicaid patients and 42.0% of commercially insured patients filled an opioid prescription. Conclusions Antibiotics and opioids are frequently prescribed during ED visits for dental conditions. Access to preventive and acute oral health care for routine dental symptoms, such as caries, may reduce unnecessary prescriptions in both the commercially insured and Medicaid beneficiary populations. Practical implications Treatment of dental conditions in the ED often indicates a lack of access to preventive or acute oral health care. Data-driven solutions, such as guideline implementation, could improve oral health access, reduce medication-related harms, and avert health care expenditures.
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Providers may continue to rely on opioids.
“providers may continue to rely on opioids.7,18,19”
From Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in adolescents, adults, and older adults (2024) · cites this paper as [7]
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- Authors
- Roberts, R. M., Bohm, M. K., Bartoces, M. G., Fleming-Dutra, K. E., Hicks, L. A., & Chalmers, N. I.
- Affiliations
- Centers for Disease Control and Prevention (US)
- United States Food and Drug Administration (US)
- Corresponding author
- Roberts, Rebecca M.
- ORCID
- Venue
- The Journal of the American Dental Association
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 151
- Issue
- 3
- Pages
- 174-181.e1
- ISSN
- 0002-8177 (ISSN-L)
- PMC
- PMC9426303
- OpenAlex
- W3000575476
- Cited by
- 22
- References
- 35
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 2 · 2021: 8 · 2020: 2
- FWCI
- 2.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of the American Dental Association (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Keywords
- antibiotic prescribing, opioid prescribing, dental emergencies, emergency department visits, Medicaid beneficiaries, private insurance, dental caries, oral health access, inappropriate prescribing, health care utilization
- MeSH terms
- Analgesics, Opioid, Anti-Bacterial Agents, Emergency Service, Hospital, Humans, Medicaid, Practice Patterns, Physicians', Retrospective Studies, United States
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