ADA: Dental-Related ER Visits Rising in the US
July 02, 2013
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Record numbers of Americans are going to emergency rooms for dental treatment, which is straining the nation’s health care system and increasing health care costs, according to new analysis released by the American Dental Association (ADA).
The research carried out by the ADA Health Policy Resources Center (HPRC) concludes the number of dental ER visits in the US jumped from 1.1 million in 2000 to 2.1 million in 2010. The study also cited an independent 2009 study by the National Emergency Department Sample (NEDS) showing that 41.8 percent of all ER visits for dental conditions were the result of dental caries (the disease that causes cavities).
While ERs can provide pain relief and treat infection, few hospitals have dentists on staff able to provide comprehensive dental care, the HPRC notes. In most cases, ER staffs provide patients with prescriptions for pain or antibiotics for infection, which ease short-term symptoms without solving the long-term underlying dental problem.
“Without further interventions from policy makers, dental ER visits are likely to increase in the future, putting additional strain on the health care system and increasing overall health care costs,” said Thomas Wall, MA, MBA, a lead author of the briefs. “Dental ER visits already cost the healthcare system up to $2 billion annually, money that is better spent on improving the dental safety net.”
According to the HPRC analysis, young adults with inadequate dental coverage are driving the surge in dental ER visits. During the past decade, decreases in private dental insurance coverage, combined with significant reductions in adult dental Medicaid programs have hit young adults particularly hard. During that time, the share of young adults (21 to 34 year olds) with a dental visit who sought treatment through an ER doubled from 1.5 percent to 3 percent, far higher than any other age group.
Unfortunately, the Affordable Care Act (ACA) does little to address the issue of rising numbers of ER dental visits, the HPRC analysis concludes, because it does not mandate dental benefits for adults, nor are dental benefits likely to be included in the essential benefit packages in insurance plans sold through most states’ exchanges under the law.
To address the problem, the HPRC is calling on policy makers to look at other ways to improve access to dental care for adults, including innovative programs currently underway across the country aimed at diverting dental patients from ERs to community health centers or private dental practices where they can receive proper, long-term care. The evidence is also compelling that providing adult dental benefits within Medicaid programs goes a long way in reducing ER visits for dental conditions. Unfortunately, state policy makers have, in general, eroded such benefits the past decade.
ADA President Robert A. Faiella, DMD, MMS, cited programs in Virginia, Maine, Michigan and Washington State that move patients out of ERs and into the dental office. “These local programs have seen significant success in getting patients into a setting—the dental chair—where they can get comprehensive treatment that by and large isn’t available in hospitals,” said Dr. Faiella. “The ADA is committed, through our Action for Dental Health Campaign, to helping dentists across the country create more of them. It’s the right care in the right place.”
Read the full HPRC Research Briefs.
In other news, due to an editing error, a June 24 ADA release about the supply of dentists and its relation to Medicaid utilization referred to an incorrect measure of the overall portion of the US population living in areas with few dentists. The wording should have been ‘unserved by a dentist,’ not ‘dental HPSAs.’ The correct text is, ‘Between 2010 and 2012, the portion of the US population considered unserved by a dentist actually decreased to less than 10 percent, lower than the equivalent measure for primary medical care providers.’ A corrected version of the full release is available.