Dental difficulties driving people to Waikato Hospital’s emergency department, study shows
People are turning up to Waikato hospital’s emergency department because dental treatment is too expensive and hard to access, a study shows.
The New Zealand Medical Journal study found that, although it was only a small percentage of people, it was putting a strain on emergency department resources.
About two people a day arrived with dental issues over the five-year study period, and one came back to ED 13 times with dental pain.
Patients were primarily male, New Zealand European or Māori, and from regions of high deprivation who tended to arrive outside work hours.
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The average age of the patients was 26 years old for males and 28 for females, which a New Zealand Dental Association access to care spokeswoman said was “very young to come to ED for a dental problem”.
“That concerns me.”
There was a free dental service for people aged 0 to 18, but after that many people struggled to access dental care, she said.
“These low income New Zealanders can’t access it and, by the time they are 26 or 27 on average, they are presenting to ED needing acute pain management.”
The association had been advocating for people with low income aged 18 to 23 years old to receive free dental care.
It was also hoping to get funding for priority groups, like low income people with diabetes or low income pregnant people.
“That would reduce the number of people needing to go at 26 and 28. Dental disease is preventable.”
Christel Yardley/Stuff
Over a five-year period, an average of two people a day turned up at Waikato Hospital emergency department with dental-related problems (file photo).
Over the last 20 years, beneficiaries have been able to access $300 a year for acute dental care.
She said the current government promised in the lead-up to the last election that would be increased to $1000.
“We are hoping that will happen.”
She said $300 might pay for an x-ray, extraction, and check-up. But, if people were turning up to the emergency department in pain, chances were that it wasn’t just one tooth and $300 wouldn’t be enough.
“It’s not the solution, but it’s the first step. The ambulance at the bottom of the cliff.”
The study said many adults reported the cost of private dental care as impossible to afford, but were not eligible for funding.
And Māori, Pasifika people, and people of low socio-economic status had higher rates of untreated decay, gum disease, and missing teeth.
Ute Grabowsky/Photothek via Getty Images
The study said the people typically needed operative intervention, but emergency department doctors did not have the resources or expertise for that (file photo).
The study said dental patients in the emergency department typically needed operative intervention, like extractions, which couldn’t happen in many emergency departments.
“This leads to management with pain relief and antibiotics, which can lead to postponement of definitive treatment,” the study concluded.
The dental association spokeswoman said symptom management helped for a few days, but these people still needed to get to a dentist for work.
“Doctors don’t have a good knowledge and ability to deal with dental problems. I share their frustration.
“They give them pain relief and the patients go away and get better and a percentage comes back because they haven’t made it to a dentist.”
Eighty-six percent of patients returned to the emergency department once, and one patient presented 13 times with dental pain, the study found.
Dental problems brought 4030 people to Waikato ED over the five years studied (file photo).
Over the five-year study period, 4030 people turned up at Waikato Hospital emergency department with dental-related problems.
This was about two people every day, and made up 0.98 per cent of all emergency department patients.
Those patients cumulatively spent 497 days in the emergency department, with 842 days of admission, and requiring 169 procedures with general anaesthetic.
Health practitioners believed this put extra strains on emergency department resources, and was preventable.
“Although dental presentations to ED represent a small proportion of hospital presentations, they should not be underestimated, as they are resource intensive, and can cause significant morbidity, and potential mortality to patients,” the study said.
“These resources could have been better utilised for emergent health concerns, and funding better distributed to primary care of dental disease.”