Emergency Room Use for Dental Pain: The Path to Opioid Abuse and Addiction

Hospital emergency room entrance outsideIf you’ve ever experienced a toothache, you understand that this kind of pain impacts much more than your mouth. The nerve endings inside the gums are sensitive, and the pain can last for a day, or for years. A toothache can have a negative impact on your overall well-being. Without regular dental care, a preventable oral health issue can escalate into unbearably painful and dangerous complications. Recent research has indicated possible associations between chronic oral infections and diabetes, heart and lung disease, stroke, and even low birth weight or premature births.

But for many people, making an appointment to see the dentist isn’t easy. Seeing the dentist might be too expensive, too far away, or otherwise inaccessible. While some basic services are covered by Medicaid in North Carolina, many other states have cut or eliminated adult dental benefits for Medicaid programs. Furthermore, finding a dentist locally that accepts Medicaid is challenging.  Additionally, fewer employers are offering dental insurance, and often times, dental benefits cover very little of the overall costs of dental care. Consequently, the emergency department may be the first (and only) choice for treatment for painful oral health issues, and as a result, the number of people using the emergency department with gum disease, cavities or abscesses has almost doubled in just the ten years from 2000 to 2010.

White pills spilling onto tableThe main problem with this increase is that the emergency department it isn’t the best place to treat long-term oral health problems. Emergency departments lack the staff and training to provide solutions other than treatment for the pain, leading to over half of patients being sent home with a prescription for an opioid, even if they don’t need it. Evidently, an increasing over-prescription of opioids from emergency rooms has become clear, as shown by the 10% increase in emergency room visits resulting in opioid prescriptions between 2001 to 2010. This increase has prompted the National Institutes of Health (NIH), for the first time, to begin funding various research projects that will help shed light on how this rise in opioid prescriptions from emergency rooms’ is contributing to the continuing abuse of these narcotics in the United States.

Recently, it was estimated that 5 to 23 percent of all prescription opioid doses dispensed are used non-medically, and one study shows that two-thirds of emergency room visits involving overdoses are due to prescription drugs. With that being said, ensuring safe methods of prescribing opioids across all medical settings is important to preventing patients, especially the young and vulnerable, from developing or maintaining an addiction. While the solution to this growing problem is not simple, it is one the North Carolina Oral Health Collaborative is working to solve.

The North Carolina Oral Health Collaborative works to resolve these types of issues by addressing oral health disparities that drive people to the emergency department in the first place. Zulayka Santiago, the Collaborative’ s Director says that, “although these issues are complex requiring systems and policy changes, we are clear that the best solutions are those that harness the brilliance of many.” It is essential that solutions to these problems are rooted in and informed by those individuals who grapple with these realities on a daily basis with evidence-based scientifically sound methods. To that end, the NCOHC is partnering with individuals and organizational representatives who have a vested interest in ensuring all North Carolinians enjoy good oral health.”  To learn more about the NCOHC’s work, please visit: www.oralhealthnc.org

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