Background: Dental care in an emergency department (ED) setting is expensive and only palliative in nature. At times a dental condition becomes so severe that admission to the hospital is required. This ten-year report analyzed inpatient hospitalization for Non-Traumatic Dental Conditions (NTDC) in Texas.

Methods: Researchers used the Inpatient Public Use Data File. Inpatient admissions with ICD 10-CM codes for NTDC as primary diagnosis and patients admitted to the hospital with a principal diagnosis of cellulitis of the face or neck secondary to NTDC were included. Descriptive statistics, percentage and crude rates per 100,000 population were calculated.

Result: 47,926 NTDC inpatient admissions were identified, of which 58% were between ages 20-64 years. Admissions for females (54.6%) was higher than males (45.6%). Non-Hispanic (NH) Whites admissions percentage were 52% whereas Hispanic admissions were 27% and NH Blacks were 14%. Total charges were calculated at $2,345,968,527 with average charges of $48,950.Charges per admission increased from $34,360 in year 2007 to $64,226 in 2016 (+86%). Medicaid covered 16.2% of patients whereas charity/self-pay were 19.7%. Medicaid paid $340,732,614 for 7,759 admissions with average charges being $43,915. During this ten year period 196 patients died of which 55 were between the ages of 20-64.

Conclusion: Public insurance and uninsured Texans bear a large portion of the cost for treatment of NTDC in an inpatient setting. An upstream, proactive approach to oral health is needed to prevent dental conditions from becoming so severe that an expensive visit to the ED and then inpatient admission is required.

Obesity is one of our country’s most pressing public health problems. The disease affects approximately 40% of adults and close to 20% of children. While the last several decades have seen a more complete understanding of the myriad of factors which contribute to the development of obesity, prevention and treatment efforts have shown only limited effectiveness. Like obesity, dental caries are also prevalent and common. Both are multifactorial in nature and share common nutritional risk factors, making dental providers uniquely positioned to deliver comprehensive care for targets that play a role in both oral health and obesity prevention. Investigators at the Center for Obesity Research and Education at the College of Public Health at Temple University and the Monell Chemical Senses Center have partnered with colleagues from the Temple University Kornberg School of Dentistry and the University of Pennsylvania School of Dental Medicine to undertake three innovative projects in the area of obesity, nutrition, and oral health. One project is developing a nutrition education program to train dental students in recognizing and addressing factors common to pediatric obesity and oral health. The second is targeting oral health and snacking behaviors to decrease young children’s preferences for sweetness. The third is investigating changes in the oral environment in persons with type 2 diabetes who undergo bariatric surgery. The symposium will include an overview of all three projects and highlight the role of multidisciplinary collaboration in their success.

The Minnesota Oral Health Project (MNOHP) is a cavity-prevention program for all eighty counties in Greater Minnesota with a mission to improve access to early caries preventative services. High-risk children in Greater Minnesota have limited access to dental care. Primary Care Medical Providers (PCMP) play an important role in primary prevention for young children and have more consistent contact with children so they can have a positive impact on prevention of cavities.

The Minnesota Departments of Health (MDH) and of Human Services (DHS) mandated the quarterly application of fluoride varnish as part of well-child care for children ages 6 months to 6 years who are on Minnesota Health Care Programs. PCMP must apply fluoride varnish in order to qualify for full reimbursement for the Child and Teen Check-up exams (Minnesota's Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Program).

Together, MNOHP and MDH have increased capacity to train primary care clinics across Minnesota for successful implementation of fluoride varnish application protocols and procedures. Both MNOHP and MDH are committed to improving access to preventive dental care for Minnesota’s children. The synergy of this partnership will provide technology support for virtual training and general technical assistance.

Cavities are preventable and children can receive adequate preventive oral care from a PCMP. Restorative care remains the role of the dentist and theoretically would be needed less frequently with good prevention. This presentation will describe MNOHP/MDH partnership efforts to work with PCMP for training and addressing barriers to implementation of early caries preventive services.

Dental disease can diminish quality of life. Knowledge about the dental disease status of adults with chronic conditions can help medical providers to deliver more precise health messaging and targeted screening for dental care.

We used data for adults, age 20+ years, from the National Health and Nutrition Examination Survey. Among adults with four chronic conditions, we examined changes in the prevalence of the three dental conditions included in the Global Burden of Disease (i.e., severe tooth loss, severe periodontitis, and untreated caries) from 1999-2004 (n=10,978) to 2011—2016 (n=12,919). Chronic conditions included three self-reported conditions – heart disease, emphysema, and stroke – and clinically assessed uncontrolled diabetes. All reported prevalence estimates were standardized by age and sex to the 2000 U.S. population and significant at p<0.05.

Prevalence of severe tooth loss, severe periodontitis, and untreated caries among all adults in 2011—2016 was 7.3%, 5.4%, and 22.8% respectively. From 1999-2004 to 2011—2016 severe tooth loss decreased for adults with uncontrolled diabetes (18.0% to 10.3%) and increased for emphysema (24.6% to 35.3%). Severe periodontitis increased among adults with heart disease (3.6% to 8.7%); emphysema (2.2% to 17.4%); and stroke (4.7% to 14.0%). Untreated caries increased for heart disease (30.9% to 41.1%); uncontrolled diabetes (23.1% to 31.0%); and stroke (29.4% to 42.5%).

Although there is no clear trend in severe tooth loss, prevalence of severe periodontitis and untreated caries, both preventable with routine dental care, has increased significantly among persons with these chronic conditions.