New research has found that patients with a poor understanding of oral health go to the dentist less, and the emergency department more, for dental needs.

The research was conducted by Jeffrey VanWormer, Ph.D., and Dr. Amit Acharya from the Center for Oral and Systemic Health at Marshfield Clinic Research Institute, and was recently published in the Journal of Rural Health.

“Among adults whose oral health literacy level was low, they were less apt to go to the dentist regularly for checkups and teeth cleanings, and were more apt to be seen in the emergency department for acute dental issues such as severe pain or infection,” said Dr. VanWormer.

The researchers had patients from Marshfield Medical Center in Marshfield and Marshfield Clinic Colby Center answer survey questions to determine their oral health literacy, visits to the dentist and other study measures. Researchers then looked at these patient’s electronic health records to determine how often they went to the emergency department in the past for dental care.

Researchers have wanted to better understand why some patients don’t go to the dentist regularly and why some go to the emergency department for dental needs, especially given the high costs of emergency care and referral back to a dentist anyway.

“Having medical and dental insurance helps greatly, but a patient’s ability to process and use the oral health information they get from the dentist’s office or other sources also seems to impact their oral health care decisions,” Dr. VanWormer said.

Dr. VanWormer said that despite the clear positive impact of improving access to low-cost dental clinics available through the Family Health Centers in northcentral Wisconsin, some patients still do not go to a dentist regularly, which is concerning from a public health perspective.

Why oral health literacy is low for some patients also remains unclear.

“Low oral health literacy is related to lower education level, but it’s not a perfect correlation. Things like costs, fear of pain or limited recognition of its importance are known reasons why some patients avoid the dentist. Until severe tooth pain or complications put them in the emergency department, knowledge of oral self-care and the prevention of periodontal disease may be a low priority for some, regardless of their education,” Dr. VanWormer said.

This research project was funded by the Research Institute internally through philanthropic support from Marshfield Clinic Health System Foundation’s general medical research fund, and study analyses were completed by Sailee Tambe, a master of public health student who took part in the Summer Research Internship Program with the Research Institute.