DENTAL EMERGENCY

In a recent study published by the American Dental Association (ADA), visits to the emergency room (ER) for dental related issues have doubled nationwide over the last decade. Last year, over 2.1 million people visited the ER for a dental “emergency”, most of which could have been prevented with regular dental visits.

In another recent collaborative study between the Rutgers School of Dental Medicine and the Rutgers Center for State Health Policy, they confirmed that most of these ER visits were for dental pain and infections that were not related to trauma. This is an increasing burden on the taxpayer and the healthcare system. ER visits can be 10 times more costly than if the treatment was performed in a dental office.

Dr. Cecile Feldman, dean of the Rutgers School of Dental Medicine, recently said the following in an ADA publication:

“The most disturbing aspect of the rise in ER dental visits is that treatment is often ineffective. In emergency rooms, there is a lack of diagnostic equipment and tools – such as dental X-ray machines – and ER physicians aren’t trained to identify and treat oral health problems. Often, they prescribe painkillers and antibiotics for infections while the underlying problem remains.”

The increase in dental ER visits supports the fact that many Americans have inadequate knowledge about the consequences of not getting regular dental check-ups. Many view dental care as a luxury and if their teeth don’t hurt and appear visually acceptable, they do not feel the need to visit a dentist.

Dental decay is the underlying cause of most ER dental visits. Dental decay does not hurt until it has affected the nerve of the tooth. Dr. Feldman states, “Tooth decay, which is almost entirely preventable, is the most common chronic illness among school-age children. Left untreated, it can result in infection, unbearable pain, loss of teeth and acute systemic infection, which in some cases can lead to death. Yet nearly one in four American children has untreated tooth decay.”

So, what are some of the underlying reasons for the increase in ER visits?  Dr. Feldman says, “For many, a visit to the dentist is unaffordable and inaccessible. More than 85 million Americans have no form of dental insurance. For those who have Medicaid, finding a dentist who accepts it can be challenging. Many dentists don’t because the reimbursement payments are a fraction of the cost of care and there is a very high administrative burden.”

I have seen many suggestions for helping address this problem. Some push for more community water fluoridation, others for dental coverage for all. While children do have coverage under some medical insurance plans, it does not extend to adults. I’m not so sure that is the answer anyway, mainly due to the cost.

Dental insurance, in general, is a broken system. Unless there is some major overhaul in the way dental care or dental insurance is delivered in this country, the ER stats will continue to rise. For now, personal responsibility and budgeting for basic preventive dental care is your best defense against future dental problems.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have, please email them to him at jpstclair@stclairdmd.com