If you developed a seriously painful toothache, would you head to the emergency room to get it taken care of? In an ideal world, probably not. But lacking access to regular care from a dentist, an estimated 830,590 Americans sought help for their dental ailments in the E.R. in 2009, according to a report released yesterday from the Pew Center on the States. That represents a 16% increase from 2006, according to the report, which pulled information on E.R. visits from a database maintained by the Agency for Healthcare Research and Quality. (The estimate is based on an analysis of hospital codes from a weighted sample of 29 million E.R. visits to nearly 1,000 hospitals, Pew says.) So why do people end up in the E.R. for problems that often could have been nipped in the bud through regular checkups, cleanings and fillings? Barriers to accessing care, Pew says. Last year an Institute of Medicine report estimated that a third of the population has difficulty getting dental care. Cost is one stumbling block. Medicaid requires that states provide dental care to kids, but reimbursement is low enough so that many dentists won?t accept the insurance program. And Medicaid dental coverage for adults is optional, which means it is often cut during budgetary hard times (like now), Shelly Gehshan , director of the Pew Children?s Dental campaign, tells the Health Blog. There is also a shortage of dentists in many areas, according to Pew. But shifting dental care to E.R.s is expensive, particularly when problems that would have been easily and cheaply fixed with routine dental visits get bad enough to require surgery and general anesthesia. ?Research shows the average costs of a Medicaid enrollee?s inpatient hospital treatment for dental problems is nearly 10 times more expensive than the cost of preventive delivered in a dentist?s office,? the report says. And hospitals generally aren?t equipped to treat toothaches and abscesses effectively, it says. ?It?s a waste of money,? says Gehshan. ?And it?s inferior care.? The folks at Pew have several recommendations for states, including school-based programs to have dental hygienists apply sealants that can prevent decay, community water fluoridation, expanding the dental workforce by using dental therapists and other alternative practitioners working under dentists? supervision and higher Medicaid reimbursement rates for dental services. ?We advocate that states pay at least as much as it costs to provide the service,? says Gehshan. The American Dental Association says in a statement that it agrees with many of the report?s recommendations. But it says the report ?misses the mark on some key points,? notably the question of a dentist shortage. The ADA, citing a projection published in 2009 in the Journal of Dental Education, says the ratio of dentists to population will increase ? which means dentists, not dental therapists or other non-dentist providers, should provide needed services. Image: iStockphoto
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More Americans Heading to E.R. For Dental Care: Report
Source: http://healthxpert.org/more-americans-heading-to-e-r-for-dental-care-report/
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