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ADA Comments on the Report "A Costly Dental Destination"

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Washington, D.C. - The American Dental Association agrees with much of the report, "A Costly Dental Destination," released today by the Pew Center on the States, which points up the burden placed on already strained hospital emergency departments by patients needing dental care. The report validates what the ADA has been saying for years:  Too many Americans face barriers that impede their ability to get dental care.  People in pain often have no recourse other than seeking care in hospital emergency rooms.   Most ERs can treat only symptoms by dispensing antibiotics and pain medication, palliatives that provide only temporary relief, meaning that the problem will persist. 

A study conducted last year by the South Carolina Dental Association showed that treatment for an abscessed tooth in a hospital emergency department—which in the majority of cases cannot cure the underlying problem—costs Medicaid on average $236 while the same problem treated by a private dentist—treatment that ends the problem—would cost the program $107.  With Medicaid funding for dental care already woefully inadequate in so many states, this is a waste of precious resources on ineffective treatment.  

States can and must do more to address oral health disparities. The best strategy is to ensure proper preventive measures.  Medicaid programs must be funded adequately to attract sufficient numbers of dentists so that program participants receive proper and regular care. Programs that help young children receive routine preventive care, whether in dental offices, pediatricians’ offices or schools, are critical.   States must be serious about preventive measures like community water fluoridation and dental sealants programs.

Unfortunately, the Pew report misses the mark on some key points.  Projections published in the Journal of Dental Education in 2009 estimate that both the ratio of dentists to population and the net number of dentists will increase, not decrease, contrary to what the Pew report states.  The idea of relegating patients with the kind of complex conditions that lead them to seek treatment in hospital emergency departments to care by so-called "midlevel dental providers" is wrongheaded. Patients whose health has deteriorated to this point deserve care from fully trained dentists.  More important, major efforts should be directed to making certain that such conditions never develop in the first place, through dramatically ramped up prevention and oral health education programs.

Surely, all can agree that no one should have to seek dental treatment in a hospital emergency room.   The inability to surmount the barriers to oral health care can result in delayed diagnosis, untreated oral diseases and conditions, compromised overall health status, and, occasionally, even death. Unfortunately, oral health continues to elude many Americans.  We believe that part of the solution involves a fundamental shift away from surgery and toward prevention.  Investing in oral health education and prevention in the near term pays off in greatly reduced costs of treating disease over time.  

About the American Dental Association

The not-for-profit ADA is the nation's largest dental association, representing 157,000 dentist members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly The Journal of the American Dental Association (JADA) is the ADA's flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit www.ada.org. For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA’s consumer website www.MouthHealthy.org.