Like many hospitals across the country, Waldo County General Hospital, in Belfast, Maine, has found itself increasingly swamped with patients seeking treatment for dental pain in its emergency department. In addition to taxing the department's overall resources, these patients were not receiving the comprehensive dental care needed to address their problems."About 20 percent of our recent ER patient encounters have involved dental pain," said Dale Kuhnert, a member of the hospital's board of directors.
Waldo County's ER could provide pain relief and treat infection, but was not staffed with dentists or equipped to treat the underlying problems. So many patients would return to the hospital with the same problems after their initial visits.
"We had a pretty high number of 'frequent flyers,'" said Mr. Kuhnert.
Waldo County's problem reflects a disturbing national trend. Recent research carried out by the ADA Health Policy Resources Center (HPRC) concludes that the number of dental ER visits in the US jumped from 1.1 million in 2000 to 2.1 million in 2010. An independent 2009 study by the National Emergency Department Sample (NEDS) showed that 41.8 percent of all ER visits for dental conditions were the result of cavities, the most common dental disease, and one that can be easily prevented.
Across the country, hospitals, dentists and other stakeholders are taking on the challenge. In early July, Waldo County General took action, opening a dental clinic within the hospital to provide dental care to low-income patients who have nowhere else to turn. The clinic treats only adults—MaineCare, the state's Medicaid program, covers dental care for children but provides almost no dental coverage to adults.
"The board realized it was high time to address this. We also wanted to underscore the fact that good dental care is part of good health care," said Mr. Kuhnert.
To qualify for the Belfast program, patients must not have seen a dentist in the previous 12 months and meet certain federal income guidelines. The staff dental hygienist can provide dental health education, teeth cleanings, preventive treatments like fluoride and sealants, and temporary fillings. Most patients pay a $10 to $20 fee, but no one is turned away because of inability to pay. Five area dentists provide comprehensive dental care for reduced fees to patients needing it, with the hospital's dental care initiative providing payment.
"Waldo County's program combines existing resources—a modest investment by the hospital and the participation of local dentists, who are slashing their fees to provide comprehensive care to patients referred by the hospital's clinic," said ADA President Robert A. Faiella, DMD, MMSc. "This is Action for Dental Health at its best, a community solution that can be replicated by hospitals and dentists nationwide."