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Uninsured Patients Turn to ERs for Dental Problems

An ER dental visit occurs every 15 seconds

A growing number of patients are seeking help in emergency rooms (ERs) for long-delayed dental care, according to an article in USA Today. An analysis of the most recent federal data by the American Dental Association (ADA) showed that dental ER visits doubled from 1.1 million in 2000 to 2.2 million in 2012, or one visit every 15 seconds.

Limited insurance coverage is a major culprit; all but 15% of dental ER visits are by the uninsured or by people with government insurance plans.

The Patient Protection and Affordable Care Act requires health plans to cover dental services for children but not for adults. Medicaid plans for adults vary by state, and Medicare generally doesn’t cover dental care at all.

By law, ERs have to see patients even if they can’t pay. But although ERs often provide little more than painkillers and antibiotics to dental patients, the visits cost more than three times as much as a routine dental visit, averaging $749 if the patient isn’t hospitalized — and costing the U.S. health care system $1.6 billion a year.

The cost of dental care is a barrier for many people. Just over a third of working-age adults in the U.S., and 64% of seniors, lacked dental coverage of any kind in 2012. Moreover, the 10% of American adults with Medicaid dental plans often can’t find dentists to take them. The ADA says that’s partly because reimbursements are so low.

Community health centers with dental clinics offer a longstanding alternative for low-cost dental care, and another newly touted option involves university dental-school clinics. The ADA pointed to referral programs across the nation that aim to get dental patients out of ERs and into treatment at dental schools. Officials say there are 125 such programs, compared with only eight a year ago.

Christopher Smith, a reggae vocalist and part-time security system installer, learned the hard way just how crucial oral health is. He had been without dental insurance for a couple of years when a filling fell out of a molar. He tried to fix it with a do-it-yourself kit, but the temporary filling came out during a concert that night. He treated it with Anbesol, a pain reliever, the next day, but the pain got worse as his jaw swelled, and he drove to the emergency room at 4 o’clock the following morning.

Doctors there referred him to a nearby dentist, who saw the worsening infection and sent him back to the ER, where his tooth was removed. At home, the infection drained into his neck, making it difficult for him to breathe. He made a third trip to the hospital ER, and as he sat in the waiting room the swelling doubled. “I could feel my windpipe close,” he said.

Doctors admitted him, cut into his neck to drain the infection, gave him strong antibiotics — and kept him in the hospital for a week. On the plus side, ER staff helped Smith sign up for Medicare, and he was referred to a dentist who has agreed to take him.

Source: USA Today; June 30, 2015.


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