Emergency Dentists, Emergency Patients, & Emergency Rooms

This week the New York Times had an article describing the problem with emergency dental patients seeking care at hospital emergency rooms rather than dental offices or clinics. Most emergency room physicians do not have the training or available equipment to accurately diagnose dental pain. The article reports that most emergency room physicians will see at least 10 dental emergencies a week. More often than not they are only able to provide a prescription for pain medication or an antibiotic. This presents a problem because patients that are addicted to pain medication can go to an emergency room and say they have a toothache. The physician has no way to confirm that they actually have a problem and so the patient may be given addictive pain medication unnecessarily to deal with the patient’s addiction not to address a real dental problem.

Having emergency room physicians dealing with toothaches increases the cost of healthcare. Many of these patients do not have resources to pay for their emergency room visit. Those that can pay and those that are insured, and medicaid, and medicare end up paying their bill through increased premiums. An emergecny room visit is much more expensive than an extraction. Seeing emergency dental patients in an emergency room is a poor use of public and private resources.

Part of the problem lies in the lack of dental benefits for adults that qualify for medicaid and medicare. The system is set up so that we society is willing to pay for emergency room visits that are more expensive than cover dental extractions and other preventive dental care for adults that are less expensive. By not covering dental care, costs are increased, care is compromised, and narcotic pain medication abuse is increased. The simple solution is for medicaid and medicare, the safety nets for those who are uninsured, to cover emergency dental care.

It is unclear how the mouth came to be viewed as an entity different from the rest of the body, that has it’s own insurance. But it’s where we are.

As a small dental practice we are trying to make emergency dental care affordable, by allowing patients to make payments. We see many patients referred by emergency rooms. It’s not enough. We need the public assistance that is willing to pay for an expensive emergency visit set up so that a relatively inexpensive extraction can be done.