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Yes, I'm currently in a bad spot dental wise, but I'm also curious.
If a person's untreated dental issue develops into complications, it then becomes a medical issue, possibly life-threatening. Would an ER/hospital be obligated to treat the underlying cause? What else is somebody supposed to do if they have no insurance and no money?
Why don't they fix your car, too?
Hospitals don't have a closet full of dentists they keep on hand for your "might turn into something" problems.
Here, the local dental schools work on sliding scale or free.
I think many people confuse "emergency" with "urgency".
In the grand scheme of things, dentistry is very low on the medical-totem-pole. ERs are generally over-packed with patients and triage needs to screen them based on severity. There are very few true dental emergencies. Toothaches are bad and require treatment but they are not emergencies. Usually it is only an emergency when a dental-related problem compromises the airway (such as Ludwig's Angina). Also trauma involving broken facial bones can be emergencies. Most hospitals have oral surgeons on call for such instances.
Many hospitals have General Practice Residencies (GPRs) which are 1-2 year programs for general dentists to gain more experience right out of dental school. I did a GPR before my specialty training. Our dental clinic had normal hours of 8am-5pm. Residents would alternate being on call from 7am-7am. It probably varies by hospital, but for us most of the times we were called in were for:
1) Trauma of the head and neck confined to soft tissue (no broken bones) where there was a laceration that needed to be stitched up (usually related to bar fights, elderly/child falls, etc.)
2) Trauma where teeth were knocked out (sports injuries, fights) and needed to be re-splinted (we had a tackle-box that contained everything we needed for a quick splint job. The patient was then instructed to go to the dental clinic first thing the next morning for an evaluation/dental xray)
3) Incision and drainage of an intraoral abscess that they ER doctor feared might compromise the airway.
4) Excessive bleeding resulting from a dental procedure performed that day, usually from a private office with no on-call service.
5) The ER physician was clueless about dentistry and thought a loose upper denture was really a jaw fracture (happened to me).
If any of the above occurred during the hours of 8am-5pm, the patient was sent upstairs to the dental clinic so the ER docs could make room for more pressing emergencies. Run of the mill toothaches and dental pain were given pain meds/sometimes antibiotics and told to contact the dental clinic first thing in the morning.
Also, teeth - in general - are not medically necessary. You can exist, thrive, eat, drink, run, think, get an education, work at a job, have children - with no teeth. So there is no "medically necessary" reason for teeth themselves to be in an emergency situation. Teeth can -cause- emergency situations, as bart0323 has already explained. But in that case, you don't need a dentist. There's another life-threatening emergency that would constitute an emergency situation with the teeth: If an abscess has infected the sinus, and the infection travelling up toward the brain or has already affected the brain. Then, it's no longer a dental problem at all. But, that is only likely to happen with people who wait for it to be an emergency, and don't go to an actual dentist while it's still a dental problem.
Yes, I'm currently in a bad spot dental wise, but I'm also curious.
If a person's untreated dental issue develops into complications, it then becomes a medical issue, possibly life-threatening. Would an ER/hospital be obligated to treat the underlying cause? What else is somebody supposed to do if they have no insurance and no money?
Go find a dental clinic for low-income patients, a local college with a dental department, or one of those dental fairs to treat poor people for free or a nominal charge.
If any of the above occurred during the hours of 8am-5pm, the patient was sent upstairs to the dental clinic so the ER docs could make room for more pressing emergencies. Run of the mill toothaches and dental pain were given pain meds/sometimes antibiotics and told to contact the dental clinic first thing in the morning.
I do the same thing now when a hospital calls my dental office with a patient with a dental issue. Send them over now. The problem is that most patients think they will get treatment for free just because the hospital called. On further thought, this is the root of the problem. There is no "access to care" problem for dental patients. There is only an "access to someone else to pay for my care" problem. I have openings an can get you into my office tomorrow morning. But I'm not going to buy your healthcare for you.
ER can give you antibiotics or something for the pain and refer you to a dentist. They aren't going to do a root canal or filling, which would probably be most tooth issues coming into an ER.
My dad took a baseball right to the mouth. He was rushed to the ER because his mouth was gushing blood and teeth dangling out of his mouth. That was an emergency. They did all they could do, got him cleaned up, bleeding managed, etc and they were able to get him into an oral surgeon quick.
Teeth can be an emergency situation, and were it life or death, they would handle it. For other things, that's what a dentist is for.
Someone answer this for me: Why would a dentist want to work in a hospital? What is their incentive?
Umm.... To help people?
Quote:
Originally Posted by toofache32
I do the same thing now when a hospital calls my dental office with a patient with a dental issue. Send them over now. The problem is that most patients think they will get treatment for free just because the hospital called. On further thought, this is the root of the problem. There is no "access to care" problem for dental patients. There is only an "access to someone else to pay for my care" problem. I have openings an can get you into my office tomorrow morning. But I'm not going to buy your healthcare for you.
Yes my priorities. To be able to pay the salaries for my 25 office staff composed of hard working women, single moms, 2 of them are grandparents, etc. A business owner only has to take out a loan once to meet payroll before he realized how big of a deal this is, but employees never do. They just assume there is a never-ending flow of money from nowhere. I get paid last.
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