Uninsured patients turn to the ER for dental problems

Without insurance that covers dental care, more patients than ever seek care in hospital emergency rooms (ERs), according to a USA Today report.

Those patients often turn to the ER when they are in severe pain, and while emergency clinicians can treat many of the cases with painkillers and antibiotics, some patients require hospital care for their dental problems, the publication reports.

ER dental visits doubled from 1.1 million in 2000 to 2.2 million in 2012, or 1 visit every 15 seconds, according to the publication's analysis of data from the American Dental Association (ADA).

Limited insurance is to blame for much of the problem, with all but 15 percent of ER visits for dental problems by uninsured patients or those with government insurance plans, according to the report.

There's a big gap in coverage, as the Affordable Care Act requires health plans to cover dental services for children but not adults. Medicare generally does not cover dental care and Medicaid coverage for adults varies by state and may only cover a limited list of dental services. The ER visits cost more than three times as much as a routine dental visit, averaging $749 if the patient doesn't require hospitalization, the report said. The result: These visits cost the U.S. healthcare system $1.6 billion a year.

Many of those ER visits could be avoided if patients saw a dentist on a regular basis, a number of dentists told the newspaper. But cost is a barrier as many people lack separate dental coverage--roughly 64 percent of seniors and a little more than a third of working-age adults didn't have dental insurance in 2012--which means they must pay for dental care out-of-pocket. Those who do have coverage via Medicaid dental plans often can't find dentists to take them as patients because reimbursement is so low. Medicaid usually only reimburses dentists about 50 percent as much as private insurers, FierceHealthPayer previously reported. 

So what's the solution? Community health centers with dental clinics have long provided care for patients at low-cost. Another newer option is dental school clinics that offer treatment for patients at lower costs. But the ADA advocates for increased coverage for adult dental care under Medicaid, the newspaper reported. 

To learn more:
- read the report in USA Today