(PO13) Hospital Rates of Apical Abscess and Systemic Conditions Before and After the Pandemic

Abstract: COVID-19 greatly disrupted dental services and access to dental care. The effects of these factors on patients' presentation with an acute apical abscess (AAA) in hospital systems are poorly studied. This study aimed to assess the association of selected systemic conditions with the rates of AAA before and after the COVID-19 pandemic. A case-control study was performed using i2b2 data from the University of Alabama at Birmingham Hospitals network. Of the 2,523 patients with apical periodontitis, 2,222 patients had AAA between March 15, 2018, and March 14, 2022, and were matched to 2,222 non-AAA patients by age, race/ethnicity, and sex. The association of AAA with systemic conditions was assessed using a conditional logistic regression model, controlling for BMI and socioeconomic condition. Prior to COVID-19 (mid-March 2018–mid-March 2020) and after mid-March 2021, there was a strong association between AAA and smoking (p < .0001). This association was not significant during the most severe phase of the pandemic (mid-March 2020-mid-March 2021) (OR: 1.38; 95% CI: 1.03-1.85, p = .17). Metformin and statin intake, and kidney disease, were not statistically associated with AAA (p > .05). AAA consistently showed a significant positive association with periodontal disease and a negative association with cardiovascular disease (p < .0001). Hyperglycemia (HbA1c > 8) was positively associated with AAA (p = .003) for the entire cohort (2018-2022) but not for individual years. COVID-19 reduced the association between AAA and smoking. AAA showed a positive association with periodontal disease but a negative association with cardiovascular disease. Hyperglycemia was significantly associated with AAA in the overall analysis.