Sign of a system in crisis

It’s teeth-grinding news to read that more Americans are heading to hospital emergency departments for dental care. Well, not for dental care, exactly, since it’s a hospital, not a dental office. Rather, more Americans are heading to hospital emergency departments for complications from not receiving any dental care, such as infections and pain.

“People showing up at emergency rooms for dental is really your sign that your system is breaking down,” said Shelly Gehshan, director for the Pew Center’s Children’s Dental Campaign. “It’s just not serving enough people. This is your symptom of a system in crisis.”

An estimated 830,590 Americans sought help for dental ailments in the ER in 2009, according to the report, representing a 16 percent increase from 2006.

A shortage of coverage, higher costs, a shortage of dentists (coupled with dentists who don’t accept Medicaid patients), and low Medicaid reimbursements all contribute to the problem. According to Pew:

•In 2009, 56 percent of Medicaid-enrolled children did not receive dental care — not even a routine exam.

A study in Washington revealed that a trip to the ER was the first “dental visit” for one in four children overall, and for roughly half the children younger than 3 and a half years.

In 2008, nearly one out of seven children ages 6 to 12 had suffered a toothache in the previous six months.

Roughly 47 million Americans live in areas that are federally designated as having a shortage of dentists.

Pew recommends that states create school-based programs to have hygienists apply sealants that can prevent decay, encourage community water fluoridation, expand the dental workforce by using dental therapists and other practitioners working under dentists’ supervision, and offer higher Medicaid reimbursement rates for dental services. Washington state earned a “B” grade, meeting five of eight criteria.

The state is knocked for reducing residents’ ability to get regular dental care, noting that as of 2011, DSHS/Provider One coverage for adult dental services was reduced to emergency services only.

Without preventive services, people end up at the ER with full-blown dental woes, creating the two-pronged problem: “It’s a waste of money,” says Gehshan. “And it’s inferior care.”

Fortunately, local children can receive preventive care through the Community Health Center of Snohomish County, which has three clinics, two in Everett and one in Lynnwood. (The health center does offer ongoing dental services to pregnant women and diabetic patients.) The Snohomish Health District maintains a list of dental resources that accept DSHS/Provider One coverage.

It is a true emergency that so many citizens lack preventive dental care, a proven health and budget saver.