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Preventable Dental Related Emergency Department Visits and Hospital Admissions: A Systematic Review of Economic
U M G Sanketha Francis1,2, Jing Jie Lai1,3, Ruvini M Hettiarachchi1
1Centre for the Business and Economics of Health, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
Objectives:
To systematically evaluate the economic burden of preventable dental-related emergency department visits (PDEDV) and preventable dental-related hospital admissions (PDHA), identify reasons for these presentations, and synthesise recommendations to reduce avoidable utilisation.
Methods:
This systematic review followed the PRISMA 2020 guidelines. A comprehensive multiple database search was conducted in PubMed, Embase, Cochrane Library, EBSCOHOST, and Web of Science for studies reporting direct and/or indirect costs of PDEDV and PDHA in any age group, published in English from 2000 to March 2026. Three calibrated reviewers screened and critically appraised the identified studies. Data including patient characteristics, estimated charges/costs, reasons for PDEDV and PDHA, and recommendations to minimise the avoidable burden were extracted. Charges/costs were inflation-adjusted and standardised to 2024 US dollars.
Results:
Of the 2600 total studies identified, 25 met the inclusion criteria. The majority were conducted in the United States and focused on direct medical costs. Uninsured individuals, public health insurance enrolees and residents of low-income areas were more likely to experience PDEDV. Mean charges per any PDEDV ranged from $409.73 to $2740.76. Mean charges per any PDHA ranged from $5234.46 to $62 298.25, while mean hospital costs ranged from $350.42 to $22 375.53. Dental caries was the commonest cause for PDEDV. Odontogenic infections were the costliest to manage, with mean charges of $2740.76 per PDEDV and $62 298.25 per PDHA. PDEDV and PDHA were primarily driven by financial barriers, socio-demographic disparities, limited access to routine dental care, and health workforce constraints. Proposed strategies focused on improving affordability and access to preventive dental care, enhancing oral health literacy, strengthening integration between medical and dental services, and expanding the dental workforce.
Conclusions:
PDEDV and PDHA, particularly those due to dental caries and odontogenic infections, impose a significant economic burden on healthcare systems, highlighting the need to reduce financial and access barriers to routine dental care for high-risk groups and priority conditions.
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