People who don’t have dental insurance are increasingly heading to hospital emergency rooms (ERs) to deal with the pain of infected teeth and gums. Unfortunately, they often end up with nothing more than a prescription for temporary pain relief, a big bill and a dental problem that remains unsolved.
This issue is becoming of critical concern in Florida, according to a new study Scott L. Tomar, DMD, MPH, DrPH, of the University of Florida College of Dentistry. Dr. Tomar led a team of researchers in examining the patterns behind hospital provision of dental care to uncover specifically why more Florida residents are turning to the ER instead of their local dentist.
According to data provided by Florida’s Agency for Health Care Administration the number of dental visits to ERs increased from 104,642 in 2005 to 163,900 in 2014. The charges for these visits more than tripled, from $47.7 million in 2014 to $193.4 million (adjusted for inflation). The primary payers for these visits in 2014 were Medicaid (38%), self-pay (38%), commercial insurance (11%), Medicare (8%), and other (5%).
The study notes that for several reasons, the state of Florida provides a particularly significant example when examining local hospital ER use for dental problems.
Florida is the nation’s third largest state and, with nearly 20 million residents, it represents about 1 in 16 Americans. Florida has the nation’s oldest age distribution, with persons aged 65 years or older comprising 18.7 per cent of the population. I t is also one of the most ethnically and racially diverse states in the union. About 3.3 million Floridians (roughly 16%) live below the federal poverty level. Many rely on Medicare or Medicaid for their health care coverage, rather than private insurance.
In an interview with Dentistry Today Dr. Tomar added that “Our Medicaid program has one of the nation’s lowest Medicaid reimbursement rates relative to commercial insurance rates, ranking it 43rd among the states. Consequently, we have one of the lowest dentist participation rates in the country and among the lowest prevalence of Medicaid-enrolled children receiving basic dental services.”
“For enrolled adults, Florida’s Medicaid program provides only emergency services (generally limited to tooth extraction or incision and drainage of an abscess), dentures, and limited denture-related services. Florida has, by far, the largest number of dentists needed to remove its 223 dental care health professional shortage area designations (849 dentists), about double that of the next-highest state (Arizona, which would need 425 dentists).”
The reasons that Florida residents head to the emergency room include dental cavities, dental abscesses, and acute gum disease. The study’s authors believe that most of these visits were preventable if patients had affordable access to basic preventive and restorative dental services.
Dr. Tomar told Dentistry Today that “Florida’s lack of coverage for basic diagnostic, preventive, and restorative dental services for adults under its Medicaid program may ultimately lead to far worse clinical outcomes and a less cost-effective approach to managing oral health.”
“Because the oral cavity is an integral part of the body, it should be considered unacceptable that Medicare provides no coverage for most basic dental services … As our profession points out, oral health is an integral part of overall health. Consequently, coverage for basic dental services should be an integral part of healthcare coverage in employer-based insurance coverage.”
Medication may help people cope with the immediate physical effects of dental disease – abscesses, pain, infection – but don’t necessarily fix the true cause of the problem. But since the symptoms fade, people delay care as their condition worsens. The end result: increased expense for more complex treatments, and potentially compromised health.
Dental health is increasingly tied to overall wellness. Untreated periodontal (gum) disease will destroy gums and bones. Oral infections have also been linked with diabetes, heart disease, stroke, respiratory, infections, breast cancer and premature births. Additional studies on the connections between periodontal and other diseases are being conducted, but it’s safe to say that dental care is critical to maintaining good health.
Dental disease is almost entirely preventable with regular preventive care and treatment. If you’ve been delaying getting dental care due to budget issues, don’t wait any longer.
A dental savings plan can cut the costs of dental care by 10%-60%. To find out more about dental savings plans, visit dentalplans.com or call 1-800-238-5163. If you’ve been delaying getting dental care due to budget issues, don’t wait any longer. A dental savings plan can cut the costs of dental care by 10%-60%. To find out more about dental savings plans, visit dentalplans.com or call 1-800-238-5163.