Is Weekend Presentation Associated With Odontogenic Infection Severity?

Abstract

Many dental infections that otherwise could be treated in-office are directly referred to emergency departments (ED) outside of normal business hours. This study sought to determine if odontogenic infections presenting to EDs were less severe on the weekends. This was a retrospective cohort study of the 2014 Nationwide Emergency Department Sample. All patients with the primary diagnosis of an oral soft tissue infection were included in the study sample. The primary study predictor was day of presentation. The study outcome was inpatient admission from the ED. A multivariate regression model was created for ED admission rate to identify independent predictors. A total of 6,560 records were included in the final sample. Overall, 34.8% of encounters occurred on the weekend, and these patients were more likely to have private insurance and reside in higher income locations. The unadjusted ED admission rate (9.4 vs 13.4%, P < .01) was lower for patients evaluated on the weekend. The multiple regression model confirmed that weekend presentation was associated with a significantly lower odds of admission (OR=0.69, P < .01). Weekend odontogenic infections were less severe than those presenting on the weekdays. Off-hour dental emergencies remain a potential source of ED waste and should be scrutinized in any reforms seeking to reduce unnecessary emergency room encounters.