Methods in Assessing Non-Traumatic Dental Care in Emergency Departments



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Recommendations

General Recommendations


  • Thoroughly define specific study populations to determine the presence and extent of the problem and for whom effective interventions can be implemented.

  • Assess data sources to determine if the required information for the study population and research question(s) of interest are included.

  • Establish whether a problem exists and quantify the size of the problem as the first stage of any study of predictive factors or interventions.

  • Identify and promote research of specific risk or predictive factors that will aid in determining what types of interventions might be most effectively implemented or best targeted.

  • Develop sets of codes and analysis methods that will most appropriately answer research questions with the underlying motivation of standardizing methods to the extent possible to allow for comparison to other studies on other populations.

  • Promote specific code sets and guidelines for analysis methods for commonly used datasets in determining NTDC or general dental ED visit count and proportion outcomes to establish the extent of the problem, and to standardize basic data collection for surveillance.

  • Encourage inclusion of commonly identified, associated predictive factors that will help determine effective intervention strategies and promote basic levels of consistency across studies, while also accounting for possible confounding effects in studies of additional predictive factors.

  • Encourage specific research on ED use for NTDCs, which includes the majority of unnecessary visits and costs, and could most effectively be addressed in the primary dental care setting.

Recommendations Specific to States


  • Thoroughly define whether the research or surveillance is for the entire state population or for a specific state sub-population of interest to determine the presence and extent of the problem, and for whom effective interventions could be implemented.

  • Assess data sources to determine if the required information for the target population and research question(s) of interest are included. If the state is part of the SEDD system, there should be some consistency in data with other states in SEDD. If the state is not in the SEDD system, research should determine if there is a sufficient data source to investigate ED dental care and how consistent the data source is with SEDD?

  • Establish whether a problem exists and quantify the size of the problem as a first stage of any investigation of predictive factors or interventions; this should be a part of state level oral health surveillance.

  • Identify and promote research on use of specific risk or predictive factors that will aid in determining what types of interventions might be most effectively implemented or best targeted.

  • Develop standardized sets of codes and analysis methods providing appropriate basic ED dental use data for state oral health surveillance systems and for state data submission to a national data repository for tracking national ED dental care, allowing for comparability across states. Additional optional data analyses can be conducted by states as desired.

  • Promote standardized sets of codes and guidelines for analysis methods for commonly used state level datasets in determining NTDC and general dental ED visit data as part of standardized state and national oral health surveillance systems. Specifically explore further use of Medicaid data for tracking ED dental care in this population.

  • Encourage inclusion of commonly identified associated predictive factors that will help determine effective intervention strategies and promote basic levels of consistency across studies, while also accounting for possible confounding effects in studies of additional predictive factors.

  • Encourage specific research on ED use for NTDCs, which includes the majority of unnecessary visits and costs, and could most effectively be addressed with state and local level interventions, and data used to promote support and resources for such intervention programs.



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