Dental Patients Seeking Care in Hospital Emergency Rooms

In an alarming new trend, people are seeking treatment for dental problems, such as toothaches, tooth abscesses and other dental problems in emergency rooms, and the numbers are rising, a new study from the Pew Center reveals.

In 2009, emergency rooms received 830,590 visits nationwide for dental conditions – a 16 percent increase from 2006. California had 83,000 emergency room visits for dental problems in 2007, North Carolina had 69,000 visits in 2009, Florida had more than 115,000 dental-related ER cases in 2010, and New York has experienced a 32 increase in emergency treatments for young children.

The financial burden associated with these visits is staggering. A study of decay-related ER visits in 2006 found that treating about 330,000 cases cost nearly $110 million. Taxpayers bear the major portion of these costs, since close to 50% of the visits are paid by Medicaid and other public programs.

In addition to being an expensive source for treatment, hospitals generally are unable to treat toothaches and dental abscesses effectively. Most emergency rooms are not staffed with dentists, and physicians and other staff are not trained to treat underlying oral health problems. Generally, they can only provide short-term relief, such as medication, to treat an infection or temporarily relieve pain. Because treatment only addresses pain or infection, most patients require subsequent care from a dentist, and a large percentage of people seeking dental care in emergency rooms have a high rate of repeat visits.

There are two primary reasons people turn to emergency rooms for dental care. The first is cost. In today’s troubled economy, with high unemployment and families struggling to pay for rent, heat, and groceries, preventive dental care is low on the list of priorities. A study in Washington state revealed that a trip to the ER was the first “dental visit” for one in four children overall, and for roughly half the children younger than 3 and one-half years. In 2009, 56 percent of Medicaid-enrolled children did not receive dental care – not even a routine exam. Also, because of low fees, many dentists do not participate in the Medicaid program. In Florida, only 10 percent of dentists participate, and a 2009 survey revealed that in nearly two-thirds of the 39 states reporting data, most dentists treated no Medicaid patients during the previous year.

The second primary reason contributing to ER visits for dental care is the growing shortage of dentists. One study projects that by 2019, there could be 7,000 fewer dentists practicing in the United States compared with the number working in 2009. But even in states with a less severe shortage, many people live far from the nearest dentist. Roughly 47 million Americans live in areas that are federally designated as having a shortage of dentists.

The tragedy is that most of these visits to the ER could be completely eliminated with preventive dental care. A routine teeth cleaning costs between $50 to $100, and the problems associated with neglect of oral health can be severe, especially in young children, who may develop fevers and dehydration from preventable dental conditions. In Florida, for example, 200 children were hospitalized in 2006 for those types of infections.

The cost to taxpayers for untreated preventable dental problems is hefty. By investing in preventive care, insuring access to treatment, expanding the number of dental practitioners, and paying reasonable Medicaid rates for dental services, both states and patients can benefit.

To read the Pew Center study, click on http://www.pewcenteronthestates.org/uploadedFiles/A%20Costly%20Dental%20Destination.pdf.