Pandemic-Associated Dental Office Closures Associated With Increased Use of Emergency Departments for Dental Conditions in Publicly Insured Children In New York State.

Abstract

Objectives: All traditional dental clinics were closed from March to May 2020 due to the COVID-19 shutdown, potentially causing additional strain on hospital emergency departments (EDs) to care for patients with dental conditions. We evaluated the impact of pandemic-associated dental office closures on the share of dental conditions managed in EDs among children on Medicaid.

Methods: We quantified the change in the dental-related ED burden among publicly insured children before, during, and after pandemic dental office closures across NY using 2018-2020 New York State (NY) Medicaid claims data among children under age 19 using a difference-in-differences approach.

Results: After controlling for seasonality, dental practice closures in 2020 in NY led to a 2.31 percentage point increase in the share of dental conditions seen in EDs (P < .01) among children on Medicaid, representing a 62% increase over 2019 levels. This was sustained even after reopening in May 2020 (1.26 percentage point increase in the reopening phase, P < .01). The increases in the dental-related ED burden during dental office closures were due to the increased use of EDs for dental conditions.

Conclusion: Lack of access to dental care during a time of significant health care system strain was associated with an increased burden on EDs from dental conditions among publicly insured children. Health care systems should consider alternatives to referral programs to dental offices to ensure publicly insured children do not fall through the dental safety net, such as by providing limited dental services on-site or incorporating urgent dental care clinics within hospitals.