More Americans are turning to the emergency room for toothaches and other avoidable dental problems, according to a new report by the Pew Center on the States.
Preventable dental conditions were the primary reason ER visits for dental problems increased 16 percent from 2006 to 2009. Most of those cases could have been avoided by regular checkups that went untreated, analysis said, but many didn't have access to a dentist.
Hospital visits can be reduced simply by strengthening oral health and reducing costs by making "modest investments to improve access to preventative care," Pew says.
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"The fact that so many Americans go to hospitals for dental care shows the delivery system is failing," says Shelly Gehshan, director of the Pew Children's Dental Campaign. "The care provided in an ER is much more expensive, and it generally doesn't solve dental problems. Most hospital ERs are not staffed with dentists, and the medical personnel who work there are not trained to treat the underlying problems of patients with untreated dental issues."
Dental-related hospital visits are fueled by the difficulty that disadvantaged people have getting regular preventive care from dentists and other types of providers. In 2009, 56 percent of Medicaid-enrolled children didn't receive any dental care including a routine exam. The access problem is driven by multiple factors, including a shortage of dentists in many areas of the United States and the fact that many dentists do not accept Medicaid-enrolled children.
The cost of ER care can be substantial. For example, in Florida, dental-related, emergency hospital visits produced charges exceeding $88 million in 2010. States are saddled with some of these expenses through Medicaid and other public programs.
Additional state information, according to the report:
California: More than 83,000 emergency visits in 2007 for preventable dental problems
North Carolina: More than 69,000 trips to ERs in 2009 due to teeth or jaw disorders
Illinois: Nearly 77,000 dental visits to metro Chicago's hospitals from 2008 to 2011
Florida: More than 115,000 dental-related ER cases in 2010
New York: A 32 percent increase in emergency treatments for young children with preventable dental problems
Maine: Dental problems were the top reason Medicaid enrollees and uninsured young people visited hospital ERs in 2006
Oregon: A 31 percent hike over three years of dental ER cases among Medicaid enrollees.
Pew's report identifies research-based, cost-effective policies states can enact that improve access to preventive dental care and saves taxpayer dollars:
- Invest in dental sealants, expand water fluoridation, and provide incentives for pediatricians to offer basic dental services.
- Address the nation's dentist shortage by licensing new types of practitioners who work under a dentist's supervision and reach more children who aren't getting care.
- Encourage more dentists to participate in Medicaid by keeping reimbursement rates high enough to cover the actual cost of care.
"The bad news is that states are paying a hefty price at a time when they can least afford it," Gehshan says. "The good news is they can make modest investments now that will improve access to care and save them money down the road."
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