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Business & Tech

Demand for Dental Care Rises But Care Remains Scarce

When no dentist is available, people turn to the ER in local hospitals.

 

A swollen jaw, fever, and a throbbing toothache are definite signs that a dental visit is needed as soon as possible. But with no dental insurance, no regular dentist and no cash to spend on costly dental treatment, many people seek hospital emergency departments for relief from dental pain and discomfort.

The ER at St. Mary’s Hospital in Athens has seen a steady rise in dental-related visits over the past four years. In 2010 the hospital recorded 226 dental-related visits, up from 159 visits in 2009; the number rose to 327 in 2011 and to 355 in 2012.

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Athens Regional Medical Center does not separately track dental-related ER visits but Registered Nurse Kathleen Kriebel, who works on the emergency services, sees a lot of patients complaining of dental pain, dental abscesses, or fractured teeth. But because most ERs don’t have dentists on staff, not much can be done to help these kinds of patients.

“All we can do for them is prescribe antibiotics and pain medication…and maybe numb the spot where they’re having pain,” Kriebel said.

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Poor oral health affects more than a person’s smile, it can cause difficulty with chewing and swallowing and speaking as well. The Center for Disease Control and Prevention reported that oral infections have been linked to other health problems, such as diabetes, stroke and even heart disease.

Patients seeking the ER for dental-related treatment contribute to the billions of dollars wasted annually because of ER misuse. The ER staff can only temporarily relieve a patient of dental pain and discomfort. If patients don't follow-up with a dentist to treat the underlying issue, then they may end up back at the ER.

There are two free clinics in Athens, Mercy Health Center and Athens Nurses Clinic (ANC) that provide free dental services for uninsured, low-income adults. Despite their good intentions, both clinics are limited in the dental services they can provide and rely heavily on volunteers; they have similar yet different approaches for handling dental patients.

Only people who have received medical care at ANC or Mercy Health Center can be treated in the weekly dental clinics. This means patients have to meet income requirements and be completely uninsured. People with medical insurance, but no dental coverage, cannot be treated at either dental clinic.

Medicare does not cover routine dental care. Medicaid coverage of dental services for adults varies by state. In Georgia it only covers emergency dental care, which officials at Georgia Department of Community Health defined as a car accident which results in an affected tooth.

ANC holds its dental clinic on Fridays, except when no volunteer dentist is available. Extractions and fillings are the only procedures offered. Appointments cannot be made and patients on the waiting list for dental treatment are called the week of and told to arrive at 8 a.m.  

Annabella Uhde, ANC’s Spanish translator who also helps with administrative duties, said the dental clinic avoids scheduling conflicts by not making appointments.

Uhde advises patients to eat a hearty breakfast and come early, because it’s impossible to predict what time they will actually see the dentist. Patients are seen in the order in which they arrive and the clinic closes around 1 p.m., after the last patient is treated.

Mercy’s dental clinic offers fillings, extractions, cleanings, and other preventative care services. It is also held on Fridays but patients are seen by appointment only and must call the first Wednesday of every month between 12 and 1 p.m. to schedule.

Leah Brannon, dental coordinator at Mercy, said sometimes the clinic has to refer outside patients to the ER, especially in cases of an infected tooth.

“We hate to because that’s not a solution [that’s] long term for them but they need to be on antibiotics to get rid of that infection,” Brannon said.

There is high demand for dental care at both clinics, but only a certain number of patients can be accepted each month. Uhde said there is a long list of patients, some who want to be called for dental care and others who just want to be put on the wait list; either option could take a month or longer before a patient is notified.  

Brannon said people call Mercy every week wanting to be seen in the dental clinic, despite the once-a-month appointment line.

 

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