Utility of Dental Informatics for Dental Research in Rural Appalachia: Observational Study (Preprint)

Abstract

Rural medical centers, especially in the Appalachian region, have limited funds and expertise to pursue the latest technologies without evidence of their definite cost/benefit. We endeavor to show that dental informatics, which combines dentistry and information technologies, can help identify strategies leading to improved care and reduced cost for a very underserved population.

Demonstrate the value of dental informatics on dental health care in rural Appalachia through a study measuring emergency room (ER) use for non-traumatic dental conditions (NTDC) and associated economic impact in a hospital system that primarily serves rural Appalachia.

The Appalachian Clinical and Translational Science Institute’s Oral health data mart with relevant data on patients (n=8372) with ER encounters for NTDC between 2010 and 2018 was created using Appalachian Clinical and Translational Science Institute’s research data warehouse. Exploratory analysis was then performed through the development of an interactive dashboard using Tableau. The overall burden of these encounters along with disparities in burden by age groups, gender, and primary payer was assessed.

Dental informatics was essential in understanding the overall problem and provided an interactive and easily comprehensible visualization of the situation. We found that ER visits for NTDC’s declined by 40% from 2010 to 2018 but a higher percentage of visits required inpatient care and surgical intervention.

Dental Informatics can provide the necessary tools and support to healthcare systems and state health departments across Appalachia to address serious dental problems. In this case, informatics helped identify that although inappropriate ER use for NTDCs diminished due to ER diversion efforts, they remain a significant burden. Policy changes to promote models that improve access to preventive care such as that divert patients from ER by integrating preventive and curative dental services with existing medical coverage are needed.