Thousands still using ERs for dental problems

More than 11,000 Greater Cincinnati residents annually take toothaches and other dental maladies to hospital emergency rooms – an expensive last resort for people who can’t afford, or can’t get to, the dentist office.

A new study out Wednesday said Medicaid ends up paying millions of dollars for people seeking emergency help for broken teeth, cavities, gum disease or abscesses left untreated too long. Often, the treatment fails to solve the underlying dental problem.

“The patients most likely to be using the emergency room for dental care are the least likely to have regular access to a dentist,” said David Maywhoor,project director for Dental Access Now, an arm of UHCAN Ohio, a health-care advocacy organization in Columbus, which wrote the report.

The dilemma faced by people who can’t afford dental care was underscored in 2011 when Kyle Willis, the 24-year-old nephew of famed local musician Bootsy Collins, died at the University of Cincinnati Medical Center of a dental infection that had spread to his brain. His relatives said Willis had put off getting care because he did not have dental insurance.

The Dental Access Now study found that in 2009, 2010 and 2011, at least 84,000 people each year went to Ohio emergency departments seeking care for dental pain from a broken tooth, a cavity, gum disease or an abscess. The study said that in southwestern Ohio, dental problems were the top reasons that people with Medicaid coverage went to ERs.

In Hamilton County, dental problems accounted for more than 17,800 ER visits over the three years, the study said. Butler and Clermont counties each had more than 6,100 ER visits for dental problems; Warren County had 1,650 visits.

The Dental Access Now study said that in Ohio from January 2010 until June 2011, dental treatment in emergency rooms cost $188.5 million. About half of the visits are billed to Medicaid or Medicare; the other half are paid out of pocket.

Maywhoor said the American Dental Association estimates that an ER visit for a dental problem can cost between $400 and $1,500. A dental office visit for the same problem might run between $40 and $200.

Wednesday’s study did not measure Kentucky visits. However, Interact for Health, the regional health care data gatherer, has found in its surveys that in Boone, Campbell, Grant and Kenton counties, 32.4 percent of respondents acknowledged avoiding or delaying dental care because they couldn’t afford it.

Francie Wolgin, senior program officer for Interact, echoed a key point in the Dental Access Now study: that ER visits are, in effect, a Band-Aid for dental problems.

“ERs usually can’t do much about your dental pain,” she said. “They’re not set up to do a full-mouth extraction. They’re not going to help you with a dental abscess. They can give you antibiotices or pain medication” and a referral to a dentist.

The Dental Access Now study said the federal government has designated 84 areas in Ohio – eight in Hamilton County alone – as dental-health professional shortage areas, where there are too few dentists and hygenists to serve the population.

Maywhoor said his organization believes an answer to the problem is a job called a dental therapist, someone who is trained and state-licensed to clean teeth, fill cavities and take care of dental problems before they become critical, at a lower overall cost.

Alaska, Minnesota and soon Maine now have this classification, which Maywhoor likened to a nurse practitioner. Maywhoor said Dental Access Now is writing proposed legislation to allow this job in Ohio.

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