Just the word can evoke feelings of irritation or severe anxiety. However, as we’re complaining about an upcoming dentist visit, we forget that an annual cleaning or a visit for a toothache is out of reach for millions of Americans. Over the past decade, the number of total emergency department (ED) visits increased and the number of ED visits for dental conditions nearly doubled. Between 2000 and 2010, the number of dental ED visits increased from 1.1 million to 2.1 million. Various estimates of the cost to treat dental conditions in the ED range from $867 million to $2.1 billion.
The majority of dental-related ED visits are for non-traumatic conditions, with the majority of patients discharged with either pain medication or antibiotics, rather than after a completed dental procedure. The principle diagnosis for 41.8% of all ED visits for dental conditions are dental caries, a preventable and treatable condition with regular dental care. Non-traumatic dental conditions, such as dental caries, are better served in a dental office, which offers expertise in oral health and continuity of care.
What is driving the use of the ED for dental care?
- Of the 172 million Americans with private insurance coverage, 45 million (26%) lack dental insurance;
- While some states offer comprehensive dental coverage under Medicaid for adults, most states offer limited coverage, emergency coverage or no coverage at all;
- More than 16 million children on Medicaid did not receive dental care, not even a routine exam;
- Nearly 49 million individuals live in an area designated as a Dental Health Professional Shortage Area (DHPSA);
- We need 9,600 new dental providers to meet current demand for existing dental care needs.
The complicated web of access to care, lack of or insufficient insurance coverage and an inability to pay out-of-pocket costs push millions of individuals to a much more expensive care setting: the emergency department (ED).
The solution is this problem is not straightforward. It requires the training of more dental providers, the expansion of dental coverage to Medicaid, Medicare, VA and privately insured populations and connecting providers with oral care experience to emergency departments to ensure more appropriate care for those who may not have easy access to a dental providers after ED discharge.
With all of this in mind, maybe we should stop and think about those without access next time we step foot in the dentist’s office.
Molly Benoit is a second year MPH in Health Policy student. She is the VP of Communications for HPSA.