Reducing the Dental Burden on Emergency Departments
March 13, 2013

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Linking the emergency department with a hospital dental clinic can reduce the burden on emergency staff and save costs, says a study.

The study was done at the VCU Medical Center, part of Virginia Commonwealth University. Researchers started a pilot program in the emergency department. People who came in with a dental complaint during most Monday through Friday daytime hours were given another care option. They could go to the Urgent Dental Care Clinic in the same hospital complex.

Data were collected before and after the program was started. Researchers wanted to see if the pilot program reduced dental-related visits to the emergency room.

In the year before the pilot program started, 2,618 patients were seen with dental-related complaints. After the program began, this dropped to 1,249 patients—a decrease of more than half. The number of dental patients with 2 or more visits to the emergency room declined by nearly two-thirds, from 353 to 119.

Of the patients who visited before the program began, 53% were not insured. About 40% had Medicare or Medicaid. The other 8% had private insurance.

Two-thirds of the problems were tooth-related. The rest were problems related to the gums, jaw joint or unspecified dental complaints. Most complaints were treated with pain medicine and an antibiotic. The total annual cost was $1.2 million.

Most patients visited the emergency room Monday through Thursday, between 7 a.m. and 4 p.m. Dental offices are open during much of that time. But the study authors point out that many patients did not have insurance. Others had Medicaid or Medicare, which do not cover adult dental treatment. Emergency rooms must treat all patients, whether or not they have insurance or the ability to pay for treatment.

The dental clinic in the study offered free and low-cost care. For example, patients were charged $40 for a surgical procedure. This fee was waived for people visiting for the first time who could not pay. People visiting more than once were required to pay the $40 fee.

Between 1% and 5% of U.S. emergency department visits are dental related. A 2006 study found that visits related to tooth decay cost $110 million each year. It found that 45% of patients making these visits had no insurance. A 2009 report found that 42% of patients treated for dental problems in an emergency department had no insurance.

The study appears in the Journal of Oral and Maxillofacial Surgery.