Dental Emergencies in Patients with/without Diabetes in Urban Epidemic Setting

Background: Along with neuropathy, retinopathy, nephropathy, peripheral vascular disease and cardiovascular disease, periodontal disease is now the sixth complication of diabetes.  Oral complications have long been implicated with diabetic patients, ranging from salivary dysfunction to severe chronic periodontitis, which lead to dental emergencies if not treated promptly.

Objective: 1) Generate period prevalence of diabetes in dental patients at Montefiore Medical Center (MMC) in the Bronx-NY;  2) Estimate the proportion of diabetic patients requiring emergency dental care; 3) Determine if there is a difference in dental emergencies between diabetic and non-diabetic dental patients.

Method: Electronic dental records were utilized to identify patients who had dental visits in a 6 month period (1/1/2011-6/30/2011) across five MMC operated dental clinics.  Patient medical records were queried and diagnoses with International Classification of Diseases-9-Clinical Modification (ICD-9) codes 250.xx for diabetes flagged.  Appropriate Current Dental Treatment (CDT) codes were used to identify types of dental visits and measure the relative odds (OR) and 95% confidence intervals (CI) for emergency dental visits between diabetic and non-diabetic patients.

Result: During the 6-month period, 65,535 dental visits were generated for 29,816 unique dental patients.  Approximately 11,085 (37.2%) had ICD-9 code 250.xx.  Frequency of visits per patient varied from 1 to 24; further analysis will be performed for statistical significance.  Diabetic dental patients were significantly more likely to be admitted for an emergency visit/extraction than non-diabetic patients with an OR of 1.2 (95%CI: 1.15 to 1.29).  Further analysis showed an increased proportion of diabetic patients seeking palliative emergency treatment (CDT-D9110) with an OR of 1.5 (95%CI: 1.32 to 1.64).

Conclusion: This data suggests diabetic patients require more frequent and emergency dental care than non-diabetic patients. Diabetics were 20% were more likely to present for emergency care/extractions and 50% more likely to present for palliative emergency dental treatment.