LDA - Louisiana Dental Association

LDA
from the editor
Dr. David N. Austin
Editor, LDA Journal
Emergency Room Dental Care
It Doesn't Make Dollars and Sense
According to an article in The Shreveport Times
on January 29, 2012, Louisiana spent $1.7
million on Medicaid patients who visited statewide
emergency rooms seeking relief from toothaches
during the fiscal year 2010-2011. The year before,
the state paid $1.66 million for the same reason,
according to the Department of Health and Hospitals
data quoted in this article.
And surprise, emergency physicians can’t extract
teeth, so those patients only received palliative care
and a referral to (usually) an oral surgeon. It is a rare
12-hour shift when an ER physician does not see an
emergency patient with a dental problem. It is also
noted that the vast majority are toothaches as the
result of caries.
A 2010 Health Resources and Services
Administration-funded report (nationwide) found
that between 1.3 percent and 2.7 percent of ER
visits that do not result in hospitalization are dental
complaints.
Although Medicaid pays for ER visits for adult
dental emergencies, it won’t cover the cost of an
extraction. It also doesn’t cover dental care for
most adults enrolled under the program. Federally
mandated dental care for Medicaid patients usually
ends at age 18. States are left on their own after that
to decide what if any dental care expense is covered.
In Louisiana, dental care for Medicaid patients ends
at age 21.
Also found in the article was that in Louisiana,
there were 13,125 ER visits in fiscal year 2010-2011
involving Medicaid enrollees seeking care for dental
problems. Each visit averaged about $130 according
to DHH.
If these same patients could go directly to a
dental office, the problem can be solved for less than
the total cost for ER services and the resulting dental
office cost. A recent South Carolina study actually
found that if the same patient went directly to a
dentist’s office and had the diseased tooth extracted,
the actual cost would be closer to $107. (South
Carolina’s costs seem more than Louisiana. Their
average Medicaid reimbursement for an ER dental
visit was $236.) What is also key is that the dental
problem is not solved when visiting the emergency
room.
Louisiana does offer extended dental benefits to
qualifying pregnant women. It is because research
showed that providing dental care during pregnancies
helps prevent pre-term births. In dollars and sense,
you get a better cost-effective return on investing
state funds. Hello, is anyone listening
Failing to offer at least emergency dental care to
Medicaid patients is NOT cost effective and WILL
jeopardize the health of the patient. And how much
does that actually cost our state It doesn’t take
a rocket scientist to realize the tremendous savings
and better use of our health dollars from this aspect
alone.
You cannot separate the health of the patient from
the health of their teeth. We know that, physicians
know that, and our government officials know that as
well.
It is past time for Louisiana to offer to Medicaid
enrollees emergency adult dental care and limited
adult dental coverage. It is a wise investment for the
limited funds available. It is a wise investment for
the health of many of our citizens.
It is time for the LDA to continue to see this go
forward.
Bath, Alison. “Dental Care Sought in ER.” The
Shreveport Times 29 Jan. 2012. 24 March 2012.
.
2 LDA Journal