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Dental Disorders Rank in Top 3 Avoidable Emergency Visits

Each year, thousands of patients are forced to visit the emergency department for tooth-related pain and disease. A new study identified it as one of the top causes of avoidable trips to the emergency room. Continue below to find out how health care policy plays a part in this phenomenon.
Sarah Handzel, BSN, RN
PUBLISHED: Wednesday, September 27, 2017

Toothaches were the top complaint among patients visiting the emergency department.

Many emergency department visits involve dental problems and disorders, according to a new study, and the data demonstrates a clear need for increased access to affordable dental care.

While there is no standard definition for an “avoidable” ED visit, researchers estimate that between 4.8 percent and 90 percent of all ED visits are avoidable or unnecessary.

Currently, avoidable is defined using several factors, including discharge diagnoses, triage scores, hospital admission data, and patient self-reported data. However, it’s difficult to use this information to create significant health care policy changes that could help avoid unnecessary ED visits.

In an attempt to better characterize and understand the nature of avoidable ED visits, researchers examined patient records spanning six years as part of a new study. More than 115,000 records were investigated, representing as many as 424 million ED visits involving patients 18 to 64 years old. Each patient in the study was evaluated in the ED and discharged home.

Toothache was the top complaint bringing patients to the ED, followed by back pain, headache, mental health issues, and sore throats. Dental disorders were also included among the top three ICD-9 discharge diagnoses, together with alcohol abuse and depressive disorders, and accounted for 3.9 percent of clinical classifications software (CCS) grouped discharge diagnoses.

Unfortunately for patients, many, if not most, EDs in the U.S. are unequipped to treat dental conditions or disorders. While a limited number of medical facilities and hospitals have dentists on staff in EDs, this is the exception rather than the rule. Most patients seeking dental care in EDs receive only pain medications or antibiotics and are referred back to dental providers in the community. But due to affordability concerns and lack of insurance coverage, patients often return to the ED for the same problem, which, in many cases, becomes more advanced.

According to the American Dental Association (ADA), the number of patients seen in EDs for the treatment of dental pain has increased from 1.1 million in 2000 to 2.1 million in 2010. As many as 80 percent of these visits can be attributed to preventable dental conditions.

The ADA estimates that if $520 million that is reimbursed by Medicaid each year for ED dental visits is instead diverted to private dental practices, care could be provided for up to 1 million additional people annually.

The authors of the study suggest increasing access to dental care, including preventative coverage expansions under programs like Medicaid, as a possible solution to this issue.

Currently, 46 states offer dental insurance coverage for adult Medicaid enrollees, but only 28 of those states provide coverage for preventative services. Additionally, the ADA suggests hospitals and other health care facilities could help to reduce the number of ED visits for dental complaints by implementing urgent dental care clinics.

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