Oral Health Professional Supply and Non-Traumatic Dental Emergency Department Visits
In 2023, counties in the northern region of the state had higher rates of non-traumatic dental-related emergency visits across all oral health conditions compared to the statewide rates.
Why Publish Oral Health Supply and Non-Traumatic Dental Emergency Department Visits?
Emergency department (ED) visit rates can be used to assess patients’ access to quality dental care. Non-traumatic dental conditions are not caused by oral trauma, and include dental caries (cavities), pulp and periapical (tooth nerve and root) diseases, and tooth loss, which are preventable with consistent good oral hygiene and routine dental care. Forgoing routine care could lead to severe, advanced dental disease progression, and along with a lack of an alternative source of dental care, could result in patients seeking dental care in the emergency department. Although EDs could treat symptoms of these dental conditions, they are not equipped to provide ongoing dental care. Counties with higher rates of ED visits for non-traumatic dental conditions may indicate areas with inadequate access to outpatient dental care. One potential factor that may reduce access to dental care is a lack of oral health professionals to prevent and treat these conditions, which could increase the number of dental-related ED visits for that county.
This set of visualizations display the rates of preventable ED visits for non-traumatic dental conditions, rates of dentists, and rates of oral health professionals (registered dental assistants, registered dental hygienists, and/or orthodontic assistants) that treat those conditions by county.
Key Findings – 2023
- The statewide rate for diseases of pulp and periapical tissues ED visits was 288.1 visits per 100,000 people, with 72.2% (n=13) of counties in the Northern region and 71.4% of counties (n=5) in the Sierra region having a higher ED rate than statewide.
- The statewide rates of dental specialists across all conditions ranged from less than 50 to 56 dentists per 100,000. Most counties in the Northern region, San Joaquin Valley region, and Sierra region had a lower than statewide rate of dental specialists across all dental conditions.
- The statewide rates of oral health professionals across all conditions ranged from less than 120 to 132 oral health professionals per 100,000. Most counties in the San Joaquin Valley region and Sierra region had a lower supply of oral health professionals compared to the statewide rates across all dental conditions.
- For all preventable dental-related visit types and in all regions, Medi-Cal represented the largest expected payer for non-traumatic dental ED visits. The San Joaquin Valley had the highest percentage of Medi-Cal as the expected payer for three dental-related visit types.
Visualization
How HCAI Created This Product
- Emergency department visits consist of treat and release ED visits from the 2023 Emergency Department Data and ED visits resulting in an inpatient admission from the 2023 Patient Discharge Data.
- ICD-10 codes to identify non-traumatic dental conditions (NTDCs) as a primary or secondary diagnosis were identified using documentation from the Association of State and Territorial Dental Directors.
- Diagnoses were grouped into three large condition groups based on previous analysis by the Agency for Healthcare Research and Quality.
- Health workforce licensure data was collected by the Department of Consumer Affairs; all data presented represents a snapshot of the active licensee population as of July 3, 2024.
- This product is based on responses to the HCAI Health Workforce License Renewal Survey data. To capture survey responses from licensees who were active in 2023, the Health Workforce data as of July 3, 2024, was used due to data collection lag. The responses to these surveys were adjusted using cell-based weighting to create estimates of the full population.
- The table below was used to identify which dentists and oral health professionals would be needed to prevent and/or treat each dental condition, based on their license type and primary area of practice (specialty), if applicable.
| Dental Conditions | Dental Specialties | Oral Health Professional Specialties |
|---|---|---|
| Dental caries | Dentist • Endodontics • General Practice • Pediatric Dentistry • Public Health • Oral and Maxillofacial Radiology | Registered Dental Assistant • Dental Anesthesiology • Endodontics • General Practice • Pediatric Dentistry • Public Health • Oral and Maxillofacial Radiology Registered Dental Hygienist |
| Diseases of pulp and periapical tissues | Dentist • Dental Anesthesiology • Endodontics • General Practice • Oral and Maxillofacial Radiology • Pediatric Dentistry • Public Health | Registered Dental Assistant • Dental Anesthesiology • Endodontics • General Practice • Oral and Maxillofacial Radiology • Oral and Maxillofacial Surgery • Pediatric Dentistry Registered Dental Hygienist |
| Loss of teeth and similar disorders of teeth and supporting structures | Dentist • Dental Anesthesiology • General Practice • Pediatric Dentistry • Periodontics • Prosthodontics • Public Health • Oral and Maxillofacial Radiology • Orthodontics | Registered Dental Assistant • General Practice • Pediatric Dentistry • Periodontics • Prosthodontics • Oral and Maxillofacial Radiology • Oral and Maxillofacial Surgery • Orthodontics Registered Dental Hygienist |
| Other dental conditions • Cracked tooth • Dentofacial anomalies • Dislocation of tooth • Disorders of tooth development and eruption • Embedded and impacted teeth • Gingival disorders • Periodontitis • Other diseases of jaws | Dentist • Dental Anesthesiology • Endodontics • General Practice • Oral and Maxillofacial Pathology • Oral and Maxillofacial Radiology • Oral and Maxillofacial Surgery • Oral Medicine • Orofacial Pain • Orthodontics • Pediatric Dentistry • Periodontics • Prosthodontics • Public Health | Registered Dental Assistant • Dental Anesthesiology • Endodontics • General Practice • Oral and Maxillofacial Pathology • Oral and Maxillofacial Radiology • Oral and Maxillofacial Surgery • Oral Medicine • Orofacial Pain • Orthodontics • Pediatric Dentistry • Periodontics • Prosthodontics • Public Health Registered Dental Hygienist Orthodontic Assistant |
Regions were defined by HCAI’s Office of Health Workforce Development and are listed below:
| Office of Health Workforce Development Region | Counties |
|---|---|
| Central Coast | Monterey, San Benito, San Luis Obispo, Santa Barbara, Santa Cruz, Ventura |
| Greater Bay Area | Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, Sonoma |
| Inland Empire | Riverside, San Bernardino |
| Los Angeles County | Los Angeles |
| Northern | Butte, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Yuba |
| Orange County | Orange |
| Sacramento Area | El Dorado, Placer, Sacramento, Yolo |
| San Diego Area | Imperial, San Diego |
| San Joaquin Valley | Fresno, Kern, Kings, Madera, San Joaquin, Stanislaus, Tulare |
| Sierra | Alpine, Amador, Calaveras, Inyo, Mariposa, Mono, Tuolumne |
Glossary
Expected Payer: The payer type that was expected to pay the greatest share of the patient’s bill at the time of discharge, not necessarily the payer type that actually paid.
| Payer Grouping | Inpatient Discharges | Emergency Department Visits |
|---|---|---|
| Medicare: A federal health insurance program funded by the Centers for Medicare & Medicaid Services (CMS) under the Social Security Amendments of 1965 that provides healthcare benefits to those aged 65 years and over and to disabled beneficiaries of any age. Includes Medicare Advantage and Medicare Fee-for-Service (Traditional Medicare). | Medicare | Medicare Part A, Medicare Part B, and Health Maintenance Organization (HMO) Medicare Risk |
| Medi-Cal: A public health insurance program that provides free or low-cost medical services and healthcare benefits to low-income individuals, financed from state and federal funds; California’s version of Medicaid. Includes Medi-Cal Managed Care and Medi-Cal Fee-for-Service. | Medi-Cal | Medicaid (Medi-Cal) |
| Private Health Insurance: Coverage by private, non-profit or commercial health plans or through organizations. Includes individual coverage purchased through Covered California, and organized charity payers (e.g., March of Dimes, Shriners). | Private Coverage | Preferred Provider Organization (PPO), Point of Service (POS), Exclusive Provider Organization (EPO), Blue Cross / Blue Shield, Commercial Insurance Company, and Health Maintenance Organization |
| Other Government: Public insurance programs other than Medicare or Medi-Cal, including federal, state, county and veteran-specific programs. | County Indigent, Other Government | CHAMPUS (TRICARE), Other Federal Program, Title V, Veterans Affairs Plan, and Other Non-Federal Programs |
| Self-Pay or Uninsured: Coverage where the greatest share of the patient’s bill is not expected to be paid by any other form of insurance or health plan. Includes uninsured patients, as well as instances when insurance does not cover the treatment, or the patient would like to keep the medical procedure private. | Other Indigent, Self-Pay | Self-Pay |
| All Other Payers: Includes payers not categorized elsewhere: Workers’ Compensation, Automobile Medical, disability insurance, third-party payment not included in any other category or stays for which no payment will be required by the facility (e.g. courtesy patients). | Workers’ Compensation, Other Payer | Automobile Medical, Disability, Workers’ Compensation Health Claim, Other |
Additional Information
Topic: Healthcare Utilization / Health Workforce
Source Link: Healthcare Utilization – Patient-Level Administrative Data / Health Workforce
Citation: HCAI – Oral Health Professional Supply and Non-Traumatic Dental Emergency Department Visits
Temporal Coverage: 2023 and 2024 (Due to data collection timelines, this product uses the 2023 Patient Discharge Data, 2023 Emergency Department Data, and Health Workforce Data as of July 3, 2024)
Spatial/Geographic Coverage: Statewide, OHWD Region, County
Frequency: Annually