Doctor, my tooth hurts: The costs of incomplete dental care in the emergency room

Lack of access to preventive dental care and to appropriate emergency dental care for those covered by Medicaid or SCHIP or those who are uninsured is a growing concern among public health professionals. In many locations, dental emergencies are treated in hospital general emergency rooms. Most dental emergency visits result from untreated dental problems; others are true emergencies. Regardless, most require follow-up care with a dentist. Patients without a regular dentist or without commercial dental insurance frequently end up in hospital emergency rooms where care is limited to what emergency room physicians are trained to do - treat pain and infection with medications and advise the patient to "see your dentist in the morning". Necessary follow-up care with appropriately trained staff may not occur. The study's objective was to collect and analyze data on dental-related emergency room visits from seven hospitals in a major metropolitan area of the U.S. These hospitals provided information for one year on all visits based on a specified set of dental-related ICD-9 diagnostic codes. Data included date of visit, age of patient, ICD-9 diagnostic code(s), source of payment (e.g., commercial insurance, government, or self-pay) and facility and physician charges. The analysis compared these costs with the projected cost of care at an "urgi-care" dental facility. Improved (more complete) care at a lower cost may result from increased access to dental services for emergencies and for patients without a regular dentist in an urgi-dental clinic that is staffed and able to treat the underlying dental condition.