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Florida Dental School Gets People out of the ER and into the Dental Chair

July 17, 2014

Florida residents without private insurance are increasingly turning to a dental school instead of the emergency room when they have severe pain.

Oral surgery residents at Nova Southeastern University College of Dental Medicine have performed about 1,300 extractions annually since they started accepting referrals from three Broward County hospitals in 2002, according to Dr. Steven Kaltman, Chair of Oral and Maxillofacial Surgery at the dental school. 

Emergency rooms throughout the country are inundated by patients seeking treatment for dental pain, and most hospitals are underequipped and not sufficiently staffed to provide comprehensive dental care. Many patients are only prescribed antibiotics to treat the infections, as well as pain medication, but the underlying dental problem is not addressed, causing the problem to worsen and the patient to return to the emergency room.

The American Dental Association’s Health Policy Institute in 2013 reported that emergency department visits for dental conditions were increasing. 

“If a patient comes to the emergency room and has a toothache that doesn’t involve swelling, the hospital staff will tell the patient that they do not need to be admitted to the hospital, but instead should make an appointment for the following day at the dental school’s clinic,” said Dr. Kaltman. 

Most state Medicaid dental programs are challenged to provide the amount and extent of care – both preventive and restorative – needed by their low-income beneficiaries because of administrative barriers dentists face in participation with the program.

Recent administrative changes to Florida’s Medicaid program may provide more covered services to adults but only if dentists can work with the limited menu of services that Medicaid will cover, according to Casey Stoutamire, a lobbyist for the Florida Dental Association (FDA). 

“It’s going to put dentists in a really tough position because the services these patients may actually need may not be covered under the Medicaid plan,” said Ms. Stoutamire. 

Dr. Kaltman agrees that the state’s Medicaid model is problematic.

“It’s always the lower economic group that we tend to see,” he said. “Most of our patients do not have any insurance. For this group of people, the emergency rooms are still the primary care center for their dental needs, there’s no question about that.”

Despite the roadblocks, Dr. Kaltman is optimistic that his residents’ experience in the dental school will inspire them to continue caring for the underserved.