139 - Distressed Communities Index as a Predictor of Pediatric Dental Trauma

Abstract:

Purpose: To determine the prevalence of traumatic dental injuries (TDIs) among pediatric patients presenting to community-level emergency departments in Texas in 2023, stratified by levels of socioeconomic distress as measured by the Distressed Communities Index (DCI).

Methods: A retrospective cross-sectional study was conducted using the 2023 Texas Emergency Department Public Use Data File. Pediatric patients aged 0-24 years presenting with TDIs were identified using relevant ICD-10 diagnostic codes (n=2,061). Patient ZIP codes were linked to DCI scores to assess community-level socioeconomic distress. Trauma-related visits were compared with non-dental-related conditions (NDRC).

Results: TDI accounted for 0.05% of ED visits among patients aged < 24 years in Texas in 2023, corresponding to a population prevalence of 19 per 100,000. Compared with NDRC, TDI visits differed significantly across age, gender, ethnicity, insurance status, total charges, admission source, discharge disposition, and socioeconomic distress (P < .05). TDIs were most common among males, individuals aged 20-24 years, Hispanic patients, Medicaid recipients, and residents of socioeconomically distressed communities. Mean visit charges were higher for TDI visits despite lower median costs. Although a disproportionate share of TDI presentations originated from distressed communities, multivariable logistic regression showed that the association between community-level distress and likelihood of a TDI visit compared to a NDRC was attenuated after adjusting for individual and contextual factors.

Conclusions: Pediatric dental trauma disproportionately presents among children from socioeconomically distressed communities. However, community-level distress alone was not independently associated with increased likelihood of ED visits for TDI, underscoring the multifactorial nature of dental trauma.

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