Too many dental emergencies lead to costly ER visits

Too many dental emergencies lead to costly ER visits

Dr. Aaron and Adam Cohn

Just last June, USA Today published a story highlighting that the number of dental- related Emergency Room visits doubled from 2000 to 2012, according to the most recent federal data by the American Dental Association. The story quoted an oral surgeon who said that he has to hospitalize patients on a weekly basis due to a dental infection that has gone untreated. “People still die today in the U.S. as a result from problems that stemmed from their teeth,” he said.

As dentists, we find ourselves asking why this continues to be the case. In a city like Miami, where we have one of the largest concentrations of dentists in the country, it cannot be for a lack of access to care. While a multitude of factors can contribute to the issue, there are a few that seem most likely.

We are always surprised that new patients still come to us with dental fears and phobias. In recent decades, advances in dentistry have been profound. Many choices of local anesthetics allow dentists to “numb” a tooth or area of the mouth to ensure that the patient experiences no sensation of pain. Many practitioners offer nitrous oxide, oral sedation or IV sedation. New imaging modalities such as Cone Beam CT offer three dimensional information for better treatment planning of large restorative cases, orthodontics, oral surgery, root canal therapy and implants. Current school of thought in both medicine and dentistry is that the doctor should always educate and involve the patient in both the decision-making process and in the understanding of procedures to be performed.

Patients often perceive dentistry to be a cost they cannot afford. Understanding dental insurance coverage is a little counter intuitive as well. For example:

Medicaid — only “medically necessary dental procedures to alleviate pain limited to emergency or infection” are covered.

“Emergency dental shall be limited to emergency oral examinations, necessary radiographs, extractions, incisions and drainage of abscesses. Adult dental services also shall include dentures, partial dentures (one upper and lower per lifetime) and related services.”

Medicare — No dental coverage is provided through Medicare. Dental insurance plans can be sold with Medicare packages, but are in no way government subsidized.

Private Dental Insurance — Dental insurance is very different than medical insurance. Unlike nearly all other forms of insurance where coverage kicks in after a deductible is met, dental insurance is capped at a maximum yearly benefit. Procedures are covered at a percentage (specific to each plan) with the patient responsible for paying the balance. There is a reason that there is a lack of understanding of dental coverage. Understanding dental costs should help patients to plan for regular visits.

According to the USA Today story, an emergency room visit by the patient not hospitalized can cost an average of $750, and thousands more if the patient needs hospitalization. In dentistry, the adage “an ounce of prevention is worth a pound of cure” certainly holds true.

Lack of trust or the perception that a dentist may value money over a patient’s best interest, we say that for every bad dentist there are 10 good ones. Certainly be wary, but not so much so that you avoid the dentist altogether. Most dentists care more for their patients and practices than you would believe. We are a passionate group of professionals; it takes a deep love for what you do to spend all day perfecting the smallest of details to make a patient’s bite feel “just right!”

Ultimately, whatever the challenges that a patient may face causing the delay in care, educating the public and stressing prevention seem to be the first necessary steps to reversing this alarming trend. No patient should end up in the emergency room as a result of something preventable.

At SmileMiami, our family dental team — Drs. Aaron, Adam and Jack Cohn — takes great pride in providing each patient with the most information, the best quality care and a promise that our recommendations are always what is best for the patient. If you are a patient that has stayed away from the dentist for fear or lack of trust, we urge you to give us a call and see if we may be just what you need to get back on the right track with your dental health and preventive regimen

Smile Miami is located at 9840 SW 77 Avenue. For more information, call 305- 598-1428 or go online at

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