Millions of Medicaid Dollars Spent on Dental Emergencies

Medicaid spent $520 million in 2012 on dental-related emergency room visits, according to a research brief issued by the American Dental Association’s Health Policy Institute. The researchers estimate that if these visits were diverted to private dental practices, which deliver more comprehensive and cost-effective care, that same $520 million would pay for about 1 million dental visits a year. Treating Medicaid patients in dental practices instead of emergency rooms would be a more efficient use of taxpayer dollars.

Unfortunately, many of these patients lack that option because Medicaid coverage does not always translate to access to care. More than 70 million adults and children rely on Medicaid, but many states do not include adult dental coverage. According to the Medicaid-CHIP State Dental Association, only about one-third of dentists accept Medicaid.

The American Dental Association’s brief notes that the number of emergency room visits for dental conditions in the United States continues to rise. In 2012, such trips cost the U.S. health care system $1.6 billion, with an average of $749 per visit.

Earlier research shows that, from 2008 to 2011, 101 people who sought care for preventable dental disease in emergency rooms died there. Most emergency departments are only equipped to provide palliative care; they can help manage symptoms, such as pain, but cannot treat the underlying health issue.

The researchers suggest that because 70 percent of these visits occur outside of normal business hours, increasing the number of dental practices with expanded office hours could reduce ER use for dental conditions. One key policy option that could expand dentists’ capacity to care for underserved populations, such as those on Medicaid and in rural communities, would be to authorize midlevel dental providers, who are analogous to physician assistants on a medical team. Working under the supervision of a dentist, these practitioners provide routine preventive and restorative care, such as filling cavities. By giving dentists another way to improve access to care, this approach can make more efficient use of taxpayer dollars by reducing the demand for dental emergency visits.