Emergency Rooms Replacing the Dentist's Office

***UPDATED: May 6, 2015*** New evidence shows that eliminating Medicaid dental benefits for adults results in a significant increase in costs for emergency care. A recent study has found that the elective status of dental coverage in California has led to a 32% increase in emergency room visits related to dental care during the six-years since it was eliminated from the state’s Medicaid program. Unfortunately, because emergency rooms are not equipped to handle dental emergencies, a majority of patients are sent home with prescriptions for painkillers, antibiotics or both. Without solving the issue, it then becomes a question of when, not if,  these patients will return. Under the health care law, the Affordable Care Act, dental coverage is not required for adults, which has several states considering altering their Medicaid options. According to a recent DentistryIQ article, the study authors concluded that an “increase in emergency visits for dental care does not effectively replace the dental office as a source of care.”

***UPDATED: September 5, 2013*** Recent research has confirmed that preventable oral infections have accounted for a significant increase in hospitalizations across America.  Scientists from Tufts University of Dental Medicine and the Harvard School of Dental Medicine collected and analyzed data between the years 2000 and 2008, finding that there have been over 61,000 hospitalizations attributed to dental abscesses, an infection surrounding the root of a tooth, often caused by untreated tooth decay.  89% of these hospitalizations occurred as an emergency situation with a mean length of stay of 2.96 days.  The average age of patients admitted was 37, with more than 18% of patients having no insurance.  Even though these infections are completely preventable with regular visits to the dentist, such emergencies were reported to have claimed the lives of 66 patients during the years of the study.

There is a dental crisis in our country that is costing Americans millions of dollars.  According to the Associated Press article, “More Americans seeking dental treatment at the ER,” by Lindsey Tanner, a recent study indicates that there has been a significant increase in emergency room visits for dental emergencies over the last few years, and the trend appears to be growing.  Unfortunately, most of the ailments involve toothaches or similar issues that are avoidable with regular dental checkups.  But with a shortage of dentists, including those unwilling to treat Medicaid patients, fewer people are able to attain routine care.

In 2010 alone, there were over 115,000 patients seen in emergency rooms across the state of Florida, treated for dental emergencies, resulting in charges exceeding $88 million.  Of those patients, 40,000 utilize the federal health care plan, Medicaid.  Aside from the obvious cost issue, there’s the problem that hospitals aren’t typically suited to treat dental patients.  They are able to control pain, which is what most patients are after, but without proper treatment, many dental issues don’t go away, leading to a return visit down the road.  Shelly Gehshan, director of the Pew’s children’s dental campaign, who is also responsible for collecting the data, claims that this growing problem is an indication of the issues within the dental care system.  South Carolina’s emergency rooms experienced a 60% increase in dental cases, 56% of children enrolled in Medicaid across the country received no dental care, and hospitals in Tennessee treated five times more dental patients than burn victims; clearly there’s something wrong with these statistics.

The cost of treating dental patients in emergency rooms is astronomical.  Visiting the dentist regularly for exams and cleanings costs approximately $50-$100 and can help avoid painful toothaches.  By foregoing these routine visits, some will not only have to endure the excruciating pain, but also the $1,000 fee for emergency room treatment.  Not only does this type of care cost significantly more, but ignoring symptoms for a prolonged period of time can be extremely dangerous.  Approximately 200 children in Florida ended up being hospitalized in 2006 for such infections.  Dr. Frank Catalanotto, a University of Florida’s College of Dentistry professor, blames the recession for contributing to the problem.  With many Americans out of work, paying for dental insurance has taken a backseat to putting food on the table or keeping a roof over your head.  Another contributing factor is the low fees provided to dentists from Medicaid.  Only 10% of dentists in Florida participate with the Medicaid program because of the lack of compensation.  These issues are simply outcomes of a much larger problem, and until something is done about the access to dental care, emergency rooms across the country can expect to see more and more patients with dental issues.

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