144 - Emergency Dental Treatment for Children With Behavioral Issues Post-COVID

Purpose: This retrospective study evaluates the impact of the COVID-19 pandemic on the number of pediatric patients reporting as dental emergencies with behavioral issues at the University of Rochester Eastman Institute for Oral Health. By comparing pre-pandemic (2017–2019) and post-pandemic (2021–2023) data, the study aims to determine whether the pandemic contributed to increased reported behavioral issues and changes in treatment modalities.

Methods: Patient records between the ages 0–17 from emergency walk-in visits during the specified periods were extracted from the AxiUm database. Data included behavioral issues (e.g., ADHD, anxiety, etc.), treatment outcomes, and patient demographics. Descriptive statistics and logistic regression analyses were applied to assess associations between the study period and behavioral issue prevalence, adjusting for potential confounders.

Results: This study compared pediatric emergency dental visits across two time periods: 2017–2019 and 2021–2023. Results revealed a statistically significant increase in the number of children seeking emergency dental care, along with a rise in cases involving reported behavioral concerns. The average age of patients presenting with behavioral issues increased significantly from a mean of 9.99 to 11.44 years. Additionally, there was a notable uptick in the number of patients exhibiting symptoms of anxiety and depression. These behavioral trends were accompanied by shifts in clinical management, including a significant increase in the use of nitrous oxide and the number of extractions performed. Conversely, there was a statistically significant decline in the number of restorations and stainless steel crowns placed. The study also found an increased number of referrals to general dentistry, oral and maxillofacial surgery (OMFS), and pediatric operating room (OR) services, highlighting the growing complexity of cases presenting in the emergency setting.

Conclusion: While there was no significant change in patient demographics, this study reveals a significant increase in pediatric emergency dental visits and children presenting with behavioral issues in the post-COVID period. Treatment strategies shifted toward increased use of nitrous oxide, fewer restorative procedures, and more extractions. Referrals to OMFS, general dentistry, and pediatric OR also rose. These trends highlight a growing need for behavioral and mental health support, age-appropriate behavior management techniques, and flexible treatment planning. In a post-COVID world, it is crucial to adapt and develop effective behavioral management skills to better support patients presenting with behavioral concerns.