Introduction: The expanding complexity of dental diseases has exposed the limitations of conventional heuristic-based therapeutic planning. Artificial Intelligence (AI) has evolved beyond diagnostic assistance to become a powerful tool in therapeutic decision-making, enabling data-driven, predictive, and personalized dental care. Material and Methods: This narrative review critically evaluates contemporary applications of artificial intelligence in therapeutic planning, prognostic assessment, and surgical execution across major dental specialties, including periodontology, endodontics, prosthodontics, orthodontics, and implantology. Evidence from machine learning, deep learning, computer vision, and robotics-based systems was synthesized to assess clinical relevance beyond diagnostic accuracy. Results: Artificial intelligence-based clinical decision support systems demonstrated improved precision in treatment planning, outcome prediction, and procedural execution. Applications such as generative prosthetic design, Artificial intelligence -guided endodontic access, implant navigation, orthodontic treatment simulation, and robotic-assisted surgery showed potential to reduce operator variability and enhance therapeutic outcomes. However, challenges related to data heterogeneity, algorithmic bias, explainability, and medico-legal accountability persist. Conclusion: Artificial Intelligence is redefining therapeutic decision-making in dentistry by augmenting clinical judgment rather than replacing it. When integrated within a human-in-the-loop framework, artificial intelligence serves as a high-level therapeutic assistant capable of improving accuracy, efficiency, and personalization of dental care. Future research must prioritize longitudinal clinical validation and ethical governance to enable safe and effective clinical translation.

Background: The COVID-19 pandemic has had a profound impact on health care systems worldwide, resulting in significant disruptions to routine medical and dental care. Dental prosthetic treatments are vital to maintaining functional and aesthetic aspects of oral health in geriatric patients. However, the decision-making process for initiating and completing such treatments can be influenced by various factors. Aim: To assess the effect of pandemic circumstances in determining the patient’s choice of the proposed prosthodontic treatment plan and factors that influence them to not accept the proposed treatment plan. Materials and Methods: This descriptive cross-sectional study randomly sampled 600 patients, assessing their acceptance of a proposed prosthodontic treatment plan during and after COVID-19. Descriptive statistics, including frequencies and percentages, were used. χ 2 tests compared explanatory variables, and cross-tabulation analysis evaluated decision-making factors influencing treatment acceptance or refusal. Results: During COVID-19, 79.3% of 300 respondents rejected the proposed treatment, while 20.7% accepted it. Post–COVID-19, 42.7% declined, and 57.4% accepted. Reasons for refusal included high costs, fear of infection, urgency for quick treatment, and dependency during COVID-19, among others, totaling 11 reasons for rejecting prosthetic treatment. Conclusions: This cross-sectional study underscores the impact of the COVID-19 pandemic on geriatric patients’ decision-making regarding dental prosthetic treatment. The findings highlight the need for national health care policies that ensure accessible, affordable, and timely prosthodontic care, especially during crises. Strengthening financial support and public health initiatives can enhance treatment acceptance rates.

Perceptions of shared decision-making among patients and dental professionals.

Pain and anxiety during dental procedures, particularly during the administration of local anaesthesia, remain major concerns in clinical dentistry. Additionally, achieving a uniform and defect-free mixture of dental restorative materials such as glass ionomer cement (GIC) is another challenge faced by practitioners. To address these issues, this paper presents Vibra-Dent, a compact, handheld prototype dental device designed to reduce pain perception and improve material mixing efficiency. The system is based on the Gate Control Theory of Pain, which states that non-painful stimuli like vibration can inhibit the transmission of pain signals to the brain. Vibra-Dent generates controlled vibrations (~80 Hz) at the site of dental procedures, stimulating A-beta nerve fibers that transmit signals faster than pain signals carried by A-delta and C fibers. This mechanism helps in reducing the perception of pain during dental treatments. In addition to pain reduction, the device provides a secondary function of assisting in the mixing of dental materials. The vibration-assisted mixing process helps reduce air bubbles and improves the uniformity of the mixture, which may enhance the strength and durability of dental restorations compared to conventional manual mixing. The hardware design of Vibra-Dent is centred around an Arduino Nano, which controls a DC vibration motor using pulse-width modulation (PWM). The system includes a potentiometer for adjustable vibration control, an OLED display for real-time monitoring of frequency and device status, and a rechargeable 5V battery for portable operation. Additional features such as a mode-switching mechanism allow the device to operate in both Pain Relief and Material Mixing modes. The device is designed as a lightweight, ergonomic handheld tool with a 3D-printed biocompatible casing, ensuring ease of use and safety in dental applications. Vibra-Dent is currently developed at the prototype level, and its performance is based on established scientific principles and engineering design. Clinical validation is considered as future work. In conclusion, Vibra-Dent offers a cost-effective, non-invasive, and dual-purpose solution that has the potential to improve patient comfort and enhance the quality of dental treatments. The project demonstrates the effective integration of embedded systems and biomedical concepts, contributing to the development of advanced dental care technologies.

Abstract Introduction: Tooth avulsion is a severe traumatic dental injury in which prognosis depends on prompt and appropriate emergency management. Dental professionals play a critical role in its management; however, variability in knowledge and preparedness has been reported. This systematic review aims to evaluate the knowledge and awareness of tooth avulsion management among dental professionals in Saudi Arabia. Materials and Methods: Comprehensive searches were performed across PubMed, Scopus, Web of Science, and EBSCO databases up to September 2025. Cross-sectional studies assessing knowledge, attitudes, or practices of dental professionals in Saudi Arabia regarding tooth avulsion management were eligible for inclusion. Two reviewers independently screened studies, extracted data, and assessed quality using the AXIS tool. Results: The initial search retrieved 57 articles. After removal of duplicates and screening, seven studies conducted between 2015 and 2025 were included, representing 2150 dental professionals from Riyadh, Jazan, Qassim, Al-Kharj, and Jeddah. All studies were cross-sectional and questionnaire-based. Overall, dental professionals demonstrated moderate to inadequate knowledge of avulsion management. Deficiencies were most evident in identifying appropriate storage media, recognizing the critical time for replantation, determining correct splinting duration, and awareness of long-term follow-up protocols. Specialists and dentists with postgraduate training scored significantly higher than undergraduates and general practitioners. Female dentists, those employed in public institutions, and those with prior exposure to workshops or training consistently achieved better knowledge scores. Four studies were rated high quality, one moderate–high, and two moderate on the AXIS appraisal. Conclusion: This review highlights persistent knowledge gaps among Saudi dental professionals in managing tooth avulsion, despite the recognized importance of prompt and correct intervention. Educational exposure, clinical experience, and professional environment strongly influenced knowledge levels. Findings underscore the need for curricular reforms, structured continuing professional development, and adoption of national evidence-based guidelines to enhance clinical preparedness and improve patient outcomes in dental trauma care.

To explore dental professionals' experiences of interprofessional collaboration between the public dental service (PDS) and home care services (HCS) in Norway, with a focus on how structural, legal, and professional factors influence access to preventive oral health care for HCS users. A qualitative design was applied, informed by phenomenological and hermeneutical approaches. Eight semi-structured interviews were conducted with dental professionals in PDS in Eastern Norway. Data were analyzed thematically using an inductive approach. Three main themes were identified: (1) Systemic and practical barriers, including fragmented administrative structures, outdated legislation, and lack of shared digital infrastructure; (2) Challenges in interprofessional collaboration, such as weak institutional anchoring, unclear role expectations, and low prioritization of oral health within HCS; (3) Prevention of oral disease, wherein participants emphasized the need for early intervention, continuity, and integration of oral health into daily care routines. Joint home visits and stable interprofessional relationships were highlighted as promising. Despite national strategies supporting integrated care, structural fragmentation and role ambiguity hinder effective collaboration. Strengthening interprofessional frameworks, updating legislation, and improving digital systems are needed to enhance access to preventive oral health care services. Oral health must be recognized as a shared responsibility across health services.

Short-term clinical success of posterior amalgam and composite restorations in public dental care: a multicenter retrospective study.

According to scientific literature, temporomandibular joint (TMJ) dysfunction is diagnosed in almost 82% of the adult population. Diagnosis of this pathology is quite complex. The phenomenon of pain that accompanies the manifestation of dysfunction is the most difficult symptom in the diagnosis and treatment of TMJ dysfunction, since it is a purely subjective characteristic. Patients with TMJ dysfunction complicated by РMFS currently constitute the most difficult group of dental patients to treat. The specificity of pain in temporomandibular joint dysfunction is that it does not have a clear boundary and location, which complicates the differential diagnosis of this ­pathology. The problem of diagnosing and treating diseases involving the peripheral nervous system and their complications with chronic pain syndrome is highly relevant, and the number of such patients shows a tendency to increase. Тoday, there is a need to study and combine the pathogenesis of TMJ dysfunction, especially complicated by myofascial pain syndrome, to ensure the development of new effective treatment programs. Aim: to analyze the nature and depth of manifestations of electroencephalogram changes in patients with temporomandibular joint dysfunction complicated by myofascial pain syndrome, in order to improve the quality of dental care. Material and methods. For a complete, comprehensive examination and treatment, we selected 84 patients with clear clinical signs of TMJ dysfunction and pain manifestations of varying degrees of intensity for the main group of the study. The selection of patients for the study was controlled, using the stratified randomization method. A control group of patients of the appropriate age range (20 people) was formed and examined separately, who had intact dentition, physiological bite forms and an absolute absence of clinical signs of dysfunctional changes in the TMJ (H = 0), including the absence of pain. The age of the patients ranged from 18 to 44 years. Of the 84 people, 62 (74%) were female, 22 (26%) were male. Results. Assessment of the effectiveness of the treatment method proposed by us is a mandatory and necessary condition for making clinical decisions based on the pathogenetic mechanism of TMJ dysfunction development complicated by РMPS. The diagnostic algorithm proposed by us, which included monitoring of the patient’s initial condition and personalized correction during treatment, revealed not only the clinical significance of the results obtained, but also significant quantitative characteristics in the form of integral indicators of the TMJ condition as a single holistic biosystem. Conclusions. According to the results of clinical examination of patients with TMJ dysfunction complicated by BMFS, it was determined: mild pain is characteristic of 34.5% of patients, moderate pain is characteristic of 57.1% of patients, severe unbearable pain is experienced by 8.3% of patients. The gender ratio of this pathology is 5.25:1 with a female predominance. A comprehensive scheme of measures for preventing disease progression, preventing complications and comprehensive treatment of TMJ dysfunction complicated by РMFS has been developed and proposed, the risk of not achieving the treatment result has been calculated: with the method we have proposed, it is minimal. An increase (p = 0.027) in the risk of not achieving the treatment effect by changing the pain syndrome with an increase in the dysfunction index H = 7 (95% CI 5.5–10) for each point of exceeding the indicator was found. It should also be noted that an increase (p = 0.027) in the risk of not achieving the treatment effect by changing the dysfunction index with an increase in the VAS index (95 % CI 2.8–2.1) for each point of exceeding the indicator value. The achieved results are satisfactory.

ABSTRACT Background/Objectives Community‐based activities are an essential component of the dentistry curriculum. This study evaluated the perception of undergraduate students participating in Community‐Based Programmes regarding their importance in professional training as dentists. Methods Participants of the ‘Happy Smile’ project in 2023 and 2024 were invited via WhatsApp and/or e‐mail to complete a questionnaire based on Likert scales, designed to collect demographic data and assess perceptions related to the development of skills and competencies established by the Brazilian National Curriculum Guidelines for dental education. Results Overall, 81.6% of students classified the community‐based learning project as ‘very important’ for their professional training. Among the actions that contributed to the students' educational objectives, the variable ‘importance in student training’ showed positive correlations with participation in organisational and/or feedback meetings ( p = 0.002), participation in training courses on standard operating protocols ( p = 0.008), participation in training of educational materials for pedagogical activities ( p = 0.002), provision of minimally invasive dental care in schools ( p = 0.002), supervised toothbrushing ( p = 0.024), and delivery of educational lectures in schools ( p = 0.006), among others. Key skills and competencies for oral health promotion included the development of non‐verbal communication ( p = 0.0001), integration into the social context ( p = 0.022), performance of clinical examination and diagnosis ( p = 0.0001), adherence to ethical principles ( p = 0.0001), and teamwork ( p = 0.0001). Conclusions The ‘Happy Smile’ community‐based learning project proved to be highly valuable for the training of future dental professionals across multiple domains. Student involvement in school‐based oral health promotion activities was directly proportional to their self‐confidence and learning outcomes.

This study aimed to investigate whether healthcare expenditures (HCEs) differed depending on whether the patients left periodontal disease (PD) untreated, despite the need for treatment. This study used public PD screening data from a municipality in Japan to identify adults aged ≥ 40 years who were found to require treatment of PD by dentists at PD screening. The presence or absence of periodontal treatment was determined by a dental visit within 180 days after the date of PD screening based on medical claims data. Annual HCE were calculated from cumulative expenditures over 2 years from the date of the presence or absence of periodontal treatment. A generalized linear model with a gamma distribution and log link function was used to calculate the relative cost ratios (RCRs) and 95% confidence intervals (95% CI), and a two-part model was used to predict annual HCEs and the difference in predicted HCEs based on dental treatment. Among 652 people (mean age: 62.6 years [1 SD=9.0], 65.5% women), 9.0% were untreated. After adjusting for the covariates, the RCR for medical, pharmaceutical, and dental costs in the untreated group compared with the treated group were 1.56 (95% CI: 1.02-2.38), 0.95 (95% CI: 0.53-1.70), and 0.14 (95% CI: 0.10-0.19), respectively. The differences in predicted HCEs were $593.5 (95% CI: -280.6, 1467.6) higher for medical, $79.9 (95% CI: -363.6, 523.4) higher for pharmaceutical, and $323.9 (95% CI: -397.3, -250.6) lower for dental. Leaving PD untreated was associated with increased HCEs, particularly medical expenditures. This study looked at whether people who were told by a dentist that they needed care for periodontal disease actually received treatment, and how this affected their healthcare costs. The research followed more than 600 adults in Japan for 2 years, comparing the cumulative healthcare costs of those who received dental care with those who did not. The results showed that people who did not treat their periodontal disease ended up spending more on medical care, even though they spent less on dental care. On average, untreated individuals had medical expenses that were around $600 higher than those who received treatment. This suggests that avoiding dental care for periodontal disease might lead to more serious health problems down the line, which can increase overall healthcare costs. Although skipping dental visits may seem like a way to save money, it could actually lead to higher medical bills in the future. These findings highlight the importance of early dental treatment not just for oral health, but also for managing overall healthcare costs and preventing other health complications.

Racial and Ethnic Variations in Dental Care Utilization and Expenditures: Associations with Usual Source of Care and Foreign-Born Status.

Currently, oral health field in our country faces numerous challenges, such as the persistently high prevalence of oral diseases, the heavy burden on medical insurance payments and there are significant regional differences in the level of dental care, so far the full medical equity across society has not yet been achieved. Health management is a key strategy to cope with these challenges. Health management consists of four components: information collection, risk factor assessment, health education and health intervention.The collection of information is the foundation of health education and health interventions. Effective health education and interventions, in turn, promote the conduct of information collection. Health management and medical care overlap in terms of service recipient, practitioner, location, and means of service, but there are different goal, focus point, service model and time span between them. The real rise of health management in our country has appeared since the year 2000. The oral health management is just beginning in our country. It is of significant realistic importance to set up an oral health system in China. It is recommended to carry out top-level design for oral health management and promote its progress from four aspects: changing concepts, cultivating talent, strengthening policy intervention and developing appropriate technique.

Oral health-related quality of life (OHRQoL) serves as a key measure for understanding how systemic health conditions affect oral health and daily functioning. This study aims to systematically analyze the research on the relationship between OHRQoL and systemic diseases using scientometric methods, with the goal of uncovering research trends, hotspots, and frontiers. Publications from the Web of Science were analyzed using GraphPad Prism, Bibliometrix, VOSviewer, and CiteSpace. Results were visualized. A total of 441 documents (2001-2024) were included. Publication output steadily increased, with a surge in 2020. Core authors, journals, and institutions were mainly from developed countries. Frequent keywords included "OHRQoL," "oral health," "impact," "validation," and "periodontal disease." Twelve keyword clusters were identified: "oral cancer," "oral squamous cell carcinoma," "breast neoplasms," "oral health," and "dental care" were key hotspots. "Osteoporosis" and "benign mucous membrane" emerged as novel themes, while "consensus," "older people," "2017 World Workshop," and "dry mouth" showed strong bursts. Research has advanced significantly, with developed countries as key contributors. Cancer, periodontitis, and the validation tools are central topics. Aging populations, and systemic or oral diseases in older adults are expected to shape future directions.

This study examines the nocebo effect in orthodontics by assessing how parental orthodontic experiences and attitudes toward dental care influence children's pain and discomfort at treatment onset. Consecutive orthodontic patients aged 12-18 years were included in this prospective observational cohort study. Parents' prior orthodontic experiences, perceptions of dental care, and pain expectations were assessed by questionnaire. Children completed the Pain Catastrophizing Scale (PCS) and the Spielberger State Trait Anxiety Inventory for Children (STAIC) before fixed appliance bonding. Follow-up questionnaires 3-5 days post-bonding assessed pain, dysfunction, medication use, and oral health impact (OHIP-14). Non-parametric tests and regression analyses were used to assess associations between parental expectations and patient-reported outcomes. Seventy patients (mean age 14.1 ± 1.7 years; 51.3% females) were included. Greater pain medication use was reported among patients whose parents had prior orthodontic experience (p = 0.038). Parental associations of orthodontic care with pain were linked to higher patient anxiety and pain catastrophizing. Regression analyses confirmed associations between parental expectations and patient orofacial dysfunction, anxiety, pain catastrophizing, and oral health impact. The study indicates a proxy nocebo effect in orthodontics, where parental experiences and perceptions influence children's pain during treatment. Addressing parental perceptions may help reduce this effect and improve treatment experiences for children and adolescents.

This literature review explores barriers to children's access to routine NHS dental care in the UK and the factors contributing to preventable presentations to emergency and urgent care. Evidence from the seven included studies identified four main themes: socioeconomic deprivation, vulnerable populations, service availability, and parental disengagement and limited oral health education. The findings suggest that poor access to routine dental services is shaped by structural and social inequalities rather than individual factors alone. Children who are looked after, autistic or otherwise vulnerable may experience additional barriers to timely and appropriate dental care. These inequalities contribute to avoidable emergency presentations for conditions that could often be prevented or managed earlier in primary dental settings. The review highlights implications for emergency nursing practice, including recognising unmet need, considering possible safeguarding concerns, communicating sensitively with families, and supporting earlier intervention and signposting to appropriate services.

Introduction: Persons diagnosed with Autism Spectrum Disorder (ASD) require adaptations to dental care that many undergraduate programmes may not explicitly treat. This cross-sectional pilot study assessed the extent of ASD-related content in Australia and New Zealand (ANZ) dental and oral health curricula and explored Oral Health Therapy students' knowledge and self-efficacy. Methods: Online surveys of academic staff across ANZ programmes and Bachelor of Oral Health Therapy students at the University of Newcastle were conducted. Quantitative data was summarised descriptively, and free text responses underwent thematic analysis. Results: Fifteen educator responses (8% of 178 invitees) suggest limited ASD-specific teaching and minimal use of simulation-based education. Among 38 student responses (from one institution), knowledge was generally foundational, but misconceptions persisted and no respondents reported high confidence in providing oral health care for Autistic patients. Interest in further training was high. Conclusions: Within the constraints of low response rates and a single institution student sample, these preliminary findings suggest opportunities to strengthen Autism-related teaching, particularly sensory adaptations, communication strategies, and experiential learning. Inferences should be considered exploratory and hypothesis generating. Limitations: Low educator responses and potential response bias due to limited external validity from a single student cohort.

Children with intellectual disabilities and related conditions (IDRC) and autism often require dental treatment in surgical settings. Studies of older adults suggest that ambulatory surgery centers (ASCs) can reduce costs without reducing quality, but it is unknown whether this is true for children with autism and IDRC and dental surgeries. This study compared outcomes among children with IDRC and autism receiving dental caries-related surgeries at ASCs and hospital outpatient departments (HOPDs). This cross-sectional analysis used Medicaid data from 29 states (2016-2020) to examine 17 552 outpatient dental surgeries in ASCs and HOPDs for children with IDRC or autism. Regression models were used to examine whether outcomes varied by setting of care (ASC vs HOPD). The following outcomes were included: days from diagnosis to surgery, Medicaid payment, emergency department (ED) visits, and hospitalization after surgery. Multivariate regression results indicate time from diagnosis to surgery was, on average, 8.7 days sooner for a child with autism and 13.2days sooner for a child with IDRC if furnished in an ASC compared with a HOPD (P < .001 for both). Average Medicaid payment was $419 and $363 less in an ASC than HOPD for a child with autism (P = .003) or IDRC (P = .02), respectively. The likelihood of an ED visit or hospitalization was lower in an ASC than HOPD for a child with IDRC (P < .001), but not autism (P > .05). Increasing use of ASCs for dental care may increase timely receipt of care and lower Medicaid costs without increasing adverse outcomes for children with autism and IDRC.

Oral health (OH) is an important part of overall health and quality of life. OH conditions are mostly preventable or treatable. Some subpopulations have worse OH than others. Detailed and up-to-date data about the OH of Canada's population are essential for improving care; reducing inequities; and guiding recent policy initiatives, such as the Canadian Dental Care Plan, and measuring their impact. Self-reported data from the 2023/2024 Canadian Oral Health Survey were used to estimate the prevalence of fair or poor OH across other OH-related conditions, oral self-care practices, and sociodemographic characteristics. Multivariable logistic regression models examined associations between reporting fair or poor OH, while controlling for sociodemographic characteristics and other covariates. About 17% of adults in Canada reported having fair or poor OH. Bivariate cross-tabulations and unadjusted regression suggested that self-reported fair or poor OH was positively associated with other OH-related conditions. Multivariable logistic regression also showed the odds of reporting fair or poor OH remained higher for people who had other OH-related conditions, including whether the person had teeth and dentures; being dissatisfied with the appearance of their teeth or dentures; having mouth pain; having untreated mouth problems; and avoiding certain foods because of mouth problems. Not having had an annual dental visit or failing to brush twice daily also increased the risk, as did being a man, a racialized person, or from a lower-income household, as well as having a lower general health status. This study found associations between self-reported fair or poor OH, other OH-related conditions, several sociodemographic characteristics, and oral self-care (hygiene) practices, reaffirming that self-reported OH continues to be useful for OH monitoring in Canada.

Oral health is a key determinant of overall wellbeing and general health, particularly in seniors who are often affected by multimorbidity and polypharmacy and may also require nursing care. The German Oral Health Studies (DMS) are population-representative epidemiologic surveys that assess oral health in Germany. This study aimed to clarify the prevalence, incidence, and progression of oral diseases in seniors using longitudinal data from the DMS • 6 cohort. The longitudinal analyses were based on data from 373 individuals who had previously participated in DMS V in 2014 as 65- to 74-year-olds (baseline) and were reexamined in 2023 as 73- to 82-year-olds (follow-up). Data on social demographics, disability, need for care, morbidity, oral functional capacity, and oral diseases were collected through social science interviews and clinical examinations. The mean age of the participants at baseline and follow-up was 69.4 ± 2.9 years and 78.3 ± 3.0 years, respectively. From baseline to follow-up, the mean number of missing teeth (excluding third molars) and incidence of edentulism increased. Furthermore, the number of replaced and unreplaced missing teeth both increased, and the mean number of missing teeth replaced with removable dentures increased. The caries incidence increased slightly, and periodontal health deteriorated. The number of teeth with probing depth (PD) ≥ 4 mm increased, whereas that of teeth with PD ≥ 6 mm remained unchanged. The proportion of participants requiring nursing care increased, and control-oriented dental service utilization decreased. Seniors lost approximately two teeth during the 9-year observation period. However, many teeth were retained at an advanced age. The challenges faced by people in higher ages are not limited to dental therapy but are complemented by lifelong dental care. Implementing preventive dental requirements during disease-related transition processes in senior women and men is challenging for the dental profession, as good oral health despite frailty and care needs must in part also be organized and ensured outside the dental practice. (Quintessence Int 2026;57(Suppl):S66-S75; doi: 10.3290/j.qi.b6955454).

Due to inadequate access to regular, affordable dental care, many patients turn to emergency departments (EDs) for the treatment of nontraumatic dental conditions (NTDCs). NTDC ED visits are a large burden on the U.S. healthcare system, with over 1.3 million visits each year and over $1 billion in associated charges. This study examines the characteristics of ED visitors and superutilizers (4+ ED visits in a calendar year) for non-dental (general) and dental reasons; investigates the cost of care for ED visitors and superutilizers; and estimates associations between patient characteristics and the likelihood of superutilization. Data obtained from the State Emergency Department Databases was used to summarise trends in visits by general and dental ED visitors and superutilizers, including visit rates and costs, across 14 states and 5 years. Logistic regression models were developed to estimate the likelihood of being dental superutilizers and superutilizers(for dental and non-dental visits) based on the characteristics of their first ED visit (age, gender, race/ethnicity, income quartile, insurance type, presence of comorbidities and state in which ED visit occurred). Of the total number of ED visitors (N = 25 905 031), the majority (92.4%) were general (non-dental) visitors; 6.4% were general superutilizers; 1.2% were dental visitors; and less than 1% (n = 2617) were dental superutilizers; dental superutilizers made up 0.2% of all superutilizers. Individuals who sought ED care for dental or non-dental reasons four or more times in a year were more likely to be white, be in the second or third quartile in terms of income, and have insurance coverage through Medicaid, other dental insurance, or to be uninsured. Finally, mean and median treatment costs for general and dental superutilizers were considerably higher than for both general and dental visitors to the ED. Individuals seeking ED care for NTDCs four or more times in a year are more likely to be white, have insurance coverage through Medicaid, Medicare or to be uninsured, and have one or more medical comorbidities. Cost of care for superutilizers is also considerably higher than for other ED visitors. Expansion of dental services for adults, particularly those on Medicaid, is needed to ensure they can access timely preventative and restorative services and avoid the burden of dental crisis requiring a visit to the ED.