Kansas City Dental School Relieves Dental Burden for Local Emergency Room
August 25, 2014
Students at the University of Missouri-Kansas City (UMKC) dental clinic and local community health centers are helping to relieve the burden a local hospital faces in treating people with severe dental pain.
Emergency rooms across the country are visited frequently by patients seeking treatment for dental pain, and most hospitals are underequipped and not sufficiently staffed to provide comprehensive dental care.
The number of dental visits to hospital emergency rooms doubled from 1.1 million in 2000 to 2.1 million in 2010, according to the Healthcare Cost and Utilization Project. That upward trend of people visiting emergency rooms for treatment of dental pain taxes hospitals' resources, with some patients visiting multiple times. And because most hospitals are unable to provide comprehensive care, they often simply prescribe antibiotics or pain medication.
Such was the case at Truman Medical Center in Kansas City before it created an emergency room referral program earlier this year with local dental clinics and community health centers.
Since the program started on Feb. 1, Truman Medical Center has referred about 250 people who visit the emergency room because of dental pain to the UMKC dental clinic; the Seton Center, which is an independent community health center; and Samuel U. Rodgers Health Center through its downtown and west side clinics, which are both Federally Qualified Health Centers (FQHCs). The UMKC dental clinic receives about 30 referrals per month, according to Dr. Michael McCunniff, chair of the school’s Department of Public Health and Behavioral Science.
Hospital staff uses an online referral system to book appointments; dentists treat the patients within 24 to 48 hours.
“We take about 12 walk-in patients every morning, and three slots are reserved for patients who presented with dental pain at Truman Medical Center the night before,” he said.
The short turnaround between the patient’s ER visit and appointment at the school’s dental clinic are factors in the program’s success, he said. Since UMKC is a dental school, people who have severe dental problems can receive treatment from the oral and maxillofacial surgery department.
Many emergency room physicians are also helping to ensure patients show up the next morning by limiting the amount of pain medication they provide.
“The emergency room is not equipped to handle dental problems, so in the past when a patient had an infection, the physician would give the patient antibiotics and pain medication, if it was needed,” said Dr. McCunniff. “But the physician would give a patient enough pain medication for two to three weeks, so the patient often would leave and not make an appointment to see the dentist, and instead return to the emergency room again when he or she ran out of pain medication.”
Three of the four clinics are on major Kansas City bus routes, making them more accessible for a safety-net population that sometimes has limited access to transportation.
Dr. McCunniff said the goal is to expand the program to include other area hospital emergency rooms and dental clinics.
“You can’t turn patients away, so if they show up at the emergency room, you have to do something,” he said. “This program is an example of a successful model that provides people the right type of care in the right setting.”