The 1% of emergency room visits for non-traumatic dental conditions in British Columbia: Misconceptions about the numbers

Abstract

In Canada, about 1% of all emergency room (ER) visits in a given year are made by patients with a primary diagnosis of a non-traumatic, non-urgent and yet preventable condition, such as tooth decay. This percentage is typically dismissed as irrelevant. Using 2013-2014 British Columbia data on ER use from the Canadian Institute for Health Information, however, we argue that the 1% figure (and its associated cost) has to be considered beyond its percentage value. In 2013-2014 alone, 12 357 non-traumatic dental visits were made to ERs in BC representing 1% of the total number of ER visits at a cost of $154.8 million to the taxpayers (across Canada, all visits to ER cost $1.8 billion/year). But the vast majority of these dental visits are discharged while the oral problem likely persists, hence taxpayer dollars are wasted. The belief that these dental-related ER visits are insignificant within the total cost for the health care system is misleading: treatment is not given, the problem is not resolved, and yet there is a high cost to taxpayers and to the society at large. Public health resources should be reallocated.KEY WORDS: Emergency room; dental emergencies; cost; public health; policy La traduction du résumé se trouve à la fin de l'article.

Providing dental insurance can positively impact oral health outcomes in Ontario

“…Improving access through universal dental coverage could reduce the use of hospital emergency departments and physician offices for non-traumatic dental problems (i.e. toothache), issues that have received significant policy attention in Canada [37][38][39][40][41][42][43][44][45][46]. Additionally, depending on the Restricted to Ontarians who visited dentist in past 12 months, and have at least one of their own teeth at the time of survey completion c Adjusted for age, sex, dental insurance, income quintile, household education, self-perceived general health, geographic peer group, and having at least one of your own teeth d Adjusted for age, sex, dental insurance, income quintile, household education, self-perceived general health and geographic peer group Table 3 Marginal effects of dental insurance on dental visiting behaviours.…”

Anxiety and anger of homeless people coping with dental care

“…However, patients attending community clinics reportedly need treatments beyond the financial resources of the clinics . Alternatively, many people in poverty prefer to self‐treat, even by extracting their own teeth, or to visit hospital emergency departments where some feel rushed, confused and stereotyped by the hospital staff . Furthermore, mental illness can exacerbate anxiety and hostile responses to stress …”

A review on oral health care in four different health care systems

“…Disposable income is virtually non-existent in these households and so oral health inequalities remain (35). Hence, low-income Canadians may rely on the availability of charitable or community dental clinics to have their needs addressed (2) or end up in hospital emergency rooms for dental pain relief (36). However, the availability of universal or subsidized oral health care does not imply that all individuals will obtain necessary treatment-given that other life priorities come into play, along with issues of dental fear and anxiety (37) and the array of other factors described above (31,32).…”