A painful problem of emergency care

During a recent conversation, a nurse, worried about people with debilitating toothaches, mentioned, "we don't have a dentist in the emergency room."

The axons in my brain reacted the way water in a saucepan does when drops of oil get added.

Why isn't there a dentist in, or near, the emergency room?

The nurse — who was doing good works through a fundraiser for people in need — noted a scenario that can seem unimaginable to financially-secure people who can pay for a dental surgeon.

It's a scenario easily recounted because health providers over the years have repeatedly described it.


A child, young adult or aging individual shows up at the ER in literal agony. An abscessed tooth has consumed the individual's life, with gums so inflamed and infected that the person can't tolerate food, a toothbrush or jaw movement without suffering.

In emergency rooms nationwide, uninsured patients experiencing this pain can expect a pain-pill prescription, an antibiotic prescription (if the infection is serious enough) and referral to a community dental clinic to have the tooth pulled.

End of story, with poor cosmetic results.

Well, that shouldn't be the end of the story. Mayo Clinic told me last week that Mayo Clinic Hospital-Saint Marys sees 50 patients per month, on average, for dental-related reasons and saw 650 people last year.

It's a tragedy full dental insurance wasn't included in the Affordable Care Act provisions.

Dental health has a marked impact upon health in general. People with diabetes, for example, should have their dentists and family doctors send health updates back and forth. That's because dental health illustrates how well glucose levels are maintained.Poor general health in diabetes also diminishes dental health.

Emergency departments, in my opinion, should be co-located with dental care so that the "emergency" dental clinic next door can develop expertise in treating urgent cases. They should have dental specialists on-site who can perform urgent procedures — right then and there — or set up follow-up dental care, at the same location the patient first arrived.

I like to think, in Rochester, that the Salvation Army Good Samaritan Clinic might find a way to squeeze into the Saint Marys renovation.


It's time health leaders take the initiative to make that happen.

If they do, a child will be able to concentrate at school. A young adult will be productive at work. A person with diabetes will have an easier time of it. And a grandmother will have good quality of life in her twilight years.

And "we don't have a dentist in the ER" will no longer be the norm.

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