Objective: The study aimed to estimate the prevalence of need for dental care among patients in the ED and assess associated characteristics. Methods: This was a cross-sectional study conducted in the emergency department (ED) of a level I trauma center between June 1 and August 31, 2009. All ED patients were prospectively screened during randomly selected 8-hour blocks of time; consenting patients completed a survey on sociodemographics and health. The treating clinician completed an oral health examination to determine the patient's need for dental care as none (continue usual care), early (need to be seen soon), or urgent (need to be seen immediately). Data were analyzed using logistic regression. Results: There were 4670 patients who presented to the ED, 2787 (59.7%) were eligible, 1190 (63.2%) consented and enrolled, and 653 (54.9%) had a dental examination. Of these, 388 (59.4%; 95% confidence interval [CI], 56%-63%) had no need for dental care, 199 (30.5%; 95% CI, 27%-34%) had an "early need," and 66 (10.1%; 95% CI, 8%-12%) had an "urgent need." Logistic regression showed the need for dental care was associated with age, ethnicity, and having not had a routine checkup/cleaning in the last 3 years. Conclusions: Of the patients presenting to the ED, 40.6% were in some need of dental care. This need was not associated with insurance or socioeconomic status as shown in previous studies. Age, ethnicity, and no routine oral care in the last 3 years were all associated with early/urgent need for oral health care.