More than 830,000 visits to the emergency room in 2009 were for preventable dental conditions, according to a new report by the Pew Charitable Trusts.That constitutes a 16 per cent increase from 2006, and is raising alarms over how accessible preventative care is to America’s most disadvantaged consumers.
“The fact that so many Americans go to hospitals for dental care shows the delivery system is failing,” said Shelly Gehshan, director of the Pew Children’s Dental Campaign.
“The care provided in an ER is much more expensive, and it generally doesn’t solve dental problems. Most hospital ERs are not staffed with dentists, and the medical personnel who work there are not trained to treat the underlying problems of patients with untreated dental issues.”
In the report, “A Costly Dental Destination,” Pew found that more than half of Medicaid-enrolled kids weren’t receiving even the most minimal dental care, including routine exams.
A number of factors are to blame here, including dentist shortages in some areas of the U.S. and the growing number of dental service providers that have stopped accepting Medicaid patients, Pew says. The latter reason alone has driven a 31 per cent spike in ER visits by Medicaid patients in Oregon in the last three years.
It can’t help matters that consumers are paying more than ever for dental insurance, which has risen at a rate of 7 per cent over the last decade, according to Aon Hewitt. The number of Americans receiving dental coverage dropped by 10 million in 2009.
And as for bills that consumers and Medicaid can’t (or won’t) cover, cash-strapped state healthcare systems are left to fend for themselves.
New York spent $31 million treating a 32 per cent spike in ER treatments for young children with preventable dental problems, and Florida saw more than 115,000 dental-related ER patients in 2010, costing the state $88 million. (See the infographic below for data from other states.)
“The bad news is that states are paying a hefty price at a time when they can least afford it,” Gehshan said. “The good news is they can make modest investments now that will improve access to care and save them money down the road.”
Here’s what Pew has in mind:
- Invest in dental sealants, expand water fluoridation, and provide incentives for pediatricians to offer basic dental services
- Address the nation’s dentist shortage by licensing new types of practitioners who work under a dentist’s supervision and reach more children who aren’t getting care
- Encourage more dentists to participate in Medicaid by keeping reimbursement rates high enough to cover the actual cost of care.
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