EDs grapple with surging demand from patients with dental problems.

Emergency departments across the country are experiencing surging demand from patients who present with toothaches and other dental problems. In a new report, the Pew Center on the States in Washington, DC, reports that ED visits for dental concerns grew by 16% between 2006 and 2009. Analysts say the main contributing factor to this problem is a severe shortage of dentists--particularly dentists willing to accept low reimbursement levels from Medicaid programs. States and EDs are responding to the problem in multiple ways. Emergency department providers report that these patients often keep returning to the ED for dental care even though the most ED providers can generally do for them is provide antibiotics and pain medication, and referral to a list of dentists. Some EDs have had success distributing dental resource sheets with the names of dental providers who are willing to establish payment plans for patients. Also, some EDs utilize patient navigators to help make dental appointments for patients with dental concerns. A number of states are considering laws that would enable mid-level dental providers to provide routine dental care at lower cost. Alaska and Minnesota already allow the practice, although the impact on EDs is not yet clear. State dental associations are fiercely opposed to the practice, and experts acknowledge that no one solution will completely solve the problem.