Dentist shortages in rural places contribute to rise in emergency-room visits for tooth trouble

The number of emergency-room visits for patients seeking dental treatment has increased, mostly because of problems that could have been prevented with regular dental visits, according to the Pew Center on the States. Most cases are in rural areas, which have a shortage of dentists. Nationwide, the number of ER dental visits increased 16 percent from 2006 to 2009, and the center suggests the trend is continuing. (New York Times photo by Stephen Crowley: A student in Barbourville, Ky., gets ready for a free exam through Kids First Dental, a mobile clinic.)

Visiting the ER for dental treatment can be 10 times more expensive than preventive care. Many visits involve the same patients seeking more care because emergency rooms aren't staffed by dentists. Doctors can offer pain relief, but not much more, and many patients can't afford follow-up treatment or can't find a dentist. "Emergency rooms are really the canary in the coal mine. If people are showing up in the ER for dental care, then we’ve got big holes in the delivery of care," said Shelly Gehshan, director of Pew’s child-dentistry campaign. "It’s just like pouring money down a hole."

The center analyzed information from 24 states, the federal Agency for Healthcare Research and Quality and dental care studies. It found that in 2009, 56 percent of children with Medicaid didn't receive dental care, ER visits for dental care increased by almost 60 percent in South Carolina, and there were 55,000 dental-related ER visits in Tennessee hospitals. Part of the problem is that few dentists participate in Medicaid programs, The Associated Press reports. The center is working with states to develop dental hygienists training programs and train non-dentists to treat cavities and other uncomplicated procedures. (Read more)