Severe Dental Infections: Hospital Outcomes and Costs
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Key facts
More than 145,000 patients were hospitalized with a periapical (tooth) abscess in 2020–2022. Reported hospital costs averaged about $35,000 when the abscess was the main diagnosis and about $86,500 when it accompanied another condition.
National Inpatient Sample study in JADA, as summarized by ADA News.
About 487,000 ED visits and 6,600 hospital admissions for non-traumatic dental conditions among Medicaid adults ages 21–64 (not dually eligible) in 2019.
Median hospital cost of a treat-and-release ED visit for adults 18–64: $158 for nontraumatic and $292 for traumatic dental conditions.
Hospital cost estimates, not patient bills, prices or savings.
How a tooth problem becomes a hospital stay
Tooth decay or advanced gum disease lets bacteria reach the tooth's root and the surrounding bone. Without treatment, an abscess can form and spread into the face and neck. The most serious infections can threaten the airway and require surgery, IV antibiotics and intensive care.
What national data show
A study of the National Inpatient Sample, published in the Journal of the American Dental Association and summarized by ADA News, found more than 145,000 patients hospitalized with a periapical abscess in 2020–2022. When the abscess was the main reason for admission, stays averaged about three days and about $35,000 in reported hospital costs. When it accompanied another condition, stays averaged about seven days and about $86,500. ADA News reports about 300 in-hospital deaths a year from periapical abscess.
The trend is not new. An earlier study in the Journal of Endodontics found these hospitalizations rose 41% between 2000 and 2008.
Who is most affected
In the 2020–2022 study, older, Black and Hispanic patients more often had higher-cost stays. Dementia, depression, substance use and metastatic cancer were linked to longer or more costly stays. These patients often have the hardest time reaching routine dental care.
Dementia and oral healthUncontrolled gum disease: the slower problem
Severe gum disease (periodontitis) is a chronic infection and inflammation of the tissue that holds the teeth. Beyond tooth loss, it is associated with poorer diabetes control and with heart disease. Treating it has been shown to improve blood sugar control in people with diabetes.
Where hospitals can intervene earlier
- In the ED: refer dental patients to real follow-up before an infection progresses
- At admission: ask about dental pain and check the mouth of patients who cannot report symptoms
- Before discharge: give patients a dental plan, not just a referral list
- In the community: name dental access in the hospital's Community Health Needs Assessment
Frequently asked questions
Can a tooth infection really be life-threatening?
Yes, rarely. Infections that spread to the neck or airway need emergency care.
Why do these hospital stays cost so much?
Patients may need imaging, surgery, IV antibiotics and several days of inpatient care, sometimes in intensive care.
Are these numbers charges or what patients pay?
They are hospital cost figures reported by the study, not patient bills.
Could these hospitalizations be prevented?
Many begin as dental problems that are treatable in a dental office, which is why early dental care matters.
Catch dental problems before they become admissions.
Please do not include patient information.
Sources
- ADA News: Factors Impacting Hospitalization for Periapical Abscess
- Journal of the American Dental Association (JADA) study
- Journal of Endodontics study summary (DrBicuspid): U.S. Sees Alarming Rise in Dental Infection Hospitalizations
- CMS, Center for Medicaid and CHIP Services: Adult Non-Traumatic Dental Condition ED Visits
- AHRQ HCUP: Emergency Dental Visit Costs
- Cochrane Review (Simpson et al., 2022): Treatment of Periodontitis for Glycaemic Control in People with Diabetes Mellitus
- American Heart Association scientific statement: Periodontal Disease and Atherosclerotic Vascular Disease (2012)