The Climbing Trend of Dental-Related ER Visits – Especially Among Young Adults

By Dr. John Luther, DentaQuest Chief Dental Officer

A record number of people are heading to hospital emergency rooms (ERs) when they have an urgent dental need, straining the nation’s health care system and increasing health care costs.

While ERs are equipped to provide pain relief and treat dental infection, few hospitals have dentists available to provide definitive dental care. Most of the time, ER staff are only able to provide a temporary fix, providing patients with prescriptions for pain or antibiotics for infection without diagnosing or resolving the underlying dental issue. This leaves the individual vulnerable to returning to the ER with the same problem or perhaps a more severe problem, which ultimately becomes more costly and painful to treat.

This month, the American Dental Association Health Policy Resources Center (HPRC) released findings which conclude that the number of dental-related ER visits in the United States jumped from 1.1 million in 2000 to 2.1 million in 2010.

According to HPRC’s research, dental ER visits cost the health care system up to $2 billion annually. HPRC found that the increase in cost is primarily driven by young adults, aged 21 to 34 years old, with inadequate dental coverage. During the last decade, decreases in private dental insurance combined with major reductions in adult dental Medicaid coverage have caused young adult dental-related ER visits to skyrocket from 1.5 percent to 3 percent--higher than any other age group.

The Affordable Care Act (ACA), as the HPRC points out, lacks the power to address this rising trend because it does not mandate dental benefits for adults. And, adult dental benefits are not be included in the essential benefit packages that insurance plans will sell through states’ exchanges under the law.

HPRC is calling on policy makers to look at other ways to improve access to dental care for adults, including innovative programs aimed at diverting dental patients from the ERs to community health centers (CHCs) or private dental practices, where they can receive preventive, continuous dental care.

Driven by our mission to improve the oral health of all, DentaQuest supports this approach. We believe that access to prevention-focused dental care is a cost-effective, valuable way to keep health care costs down. Our programs, such as the Strengthening the Oral Health Safety Net Initiative, the National Interprofessional Initiative on Oral Health, and Oral Health 2014, invest in national and community-based actions that engage communities across the country to create conditions for optimal oral health through prevention support and access to oral health care.

In the next decade, I am hopeful that our collaboration with policy makers and other key stakeholders will result in the reversal of this climbing negative trend.

Check Out Our New Infographic

DentaQuest is driven by our mission to improve the oral health of all, to achieve a nation free of dental disease. We strive for a nation where no child suffers from the pain of tooth decay, where adults keep all their teeth for their entire lives and where every person has access to quality dental care.

Although we have seen tremendous improvement in the oral health of Americans, the journey to solving the oral health crisis is far from over. Part of achieving this mission is educating the public about the state of oral health care and access in our nation. As a small part of our efforts, we have created this infographic to spread awareness around oral health.

Did you know:

• Dental disease (cavities) is the most common chronic disease in children. It is five times more common than asthma.

• Every year across the United States, children miss 51 million school hours due to dental problems and visits, and adults lose close to 164 million work hours.

• More than a quarter of all Americans 60 years of age or older have lost all of their teeth.

• It is estimated that in 2010, Americans spent $106 billion dollars on oral care.

• About 1 in 4 non-elderly adults have untreated tooth decay. The rate among low-income adults is twice that for adults with more income (41% versus 19%).

• An estimated 17 million low-income children in America go without dental care each year. This represents about 1 out of every 5 children.

• More than 64 million Americans have moderate to severe forms of periodontal disease.

• Dental disease is nearly 100% preventable.

Any of these facts surprise you? Help us spread the word by sharing this infographic on social media. Feel free to give us a shoutout on Twitter using our handle, @DentaQuest, to join and encourage others to join the oral health online conversation.

Partial Caries Removal is Alternative to Traditional Dental Practices

By Dr. John Luther, DentaQuest Chief Dental Officer

Nicknamed the “father of operative dentistry” in the 1990s, Greene Vardiman Black (more commonly known as GV Black) advocated that all dentin, or the tissue that surrounds a tooth, where decay is present should be removed.
 
However, recently new evidence published in a study in the Journal of Esthetic and Restorative Dentistry contradicts this dental tradition. This recent study reveals evidence that partial caries removal may be more beneficial for both the patient and practitioner.

Co-authors Daniel Chan, DMD, a professor and the associate dean of clinical services at the University of Washington School of Dentistry, and William Browning, DDS, a professor in the department of restorative dentistry at the Indiana School of Dentistry, cited several studies that support the belief that the complete removal of all the affected dentin in deep carious lesions leads to pulp exposure, complex and higher-cost treatment, and, possibly, extraction. It also suggests that creating a sealant barrier is just as effective as total removal, but with more advantages. The approach is supported by numerous clinical trials and systematic reviews, which is decidedly rare for operative dental procedures.

This study provides great insight for dentists nationwide. At DentaQuest, we support new innovative research, like the study mentioned above, that challenges and improves overall dental care. We want to help oral health care providers improve their practice to emphasize prevention and disease management. We identify promising strategies for quality improvement and, working with clinical partners, provide technical assistance to accomplish the goal.

We look forward to new research that helps transform the dental industry and ultimately how dental care is delivered.