Maine Hospital Opens Dental Clinic to Alleviate ER Burdens

Like many hospitals across the country, Waldo County General Hospital, in Belfast, Maine, has found itself increasingly swamped with patients seeking treatment for dental pain in its emergency department. In addition to taxing the department’s overall resources, these patients were not receiving the comprehensive dental care needed to address their problems.

“About 20 percent of our recent ER patient encounters have involved dental pain,” said Dale Kuhnert, a member of the hospital’s board of directors.

Waldo County’s ER could provide pain relief and treat infection, but was not staffed or equipped to treat the underlying problems. So many patients would return to the hospital with the same problems after their initial visits.

“We had a pretty high number of ‘frequent flyers,’” said Mr. Kuhnert.

Waldo County’s problem reflects a disturbing national trend. Recent research carried out by the ADA Health Policy Resources Center (HPRC) concludes that the number of dental ER visits in the US jumped from 1.1 million in 2000 to 2.1 million in 2010. An independent 2009 study by the National Emergency Department Sample (NEDS) showed that 41.8 percent of all ER visits for dental conditions were the result of cavities, the most common dental disease, and one that can be easily prevented.

Across the country, hospitals, dentists and other stakeholders are taking on the challenge. In early July, Waldo County General took action, opening a dental clinic within the hospital to provide dental care to low-income patients who have nowhere else to turn. The clinic treats only adults—MaineCare, the state’s Medicaid program, covers dental care for children but provides almost no dental coverage to adults.

“The board realized it was high time to address this. We also wanted to underscore the fact that good dental care is part of good health care,” said Mr. Kuhnert.

To qualify for the Belfast program, patients must not have seen a dentist in the previous 12 months and meet certain federal income guidelines. The staff dental hygienist can provide dental health education, teeth cleanings, preventive treatments like fluoride and sealants, and temporary fillings. Most patients pay a $10 to $20 fee, but no one is turned away because of inability to pay. Five area dentists provide comprehensive dental care for reduced fees to patients needing it, with the hospital’s dental care initiative providing payment.

“Waldo County’s program combines existing resources—a modest investment by the hospital and the participation of local dentists, who are slashing their fees to provide comprehensive care to patients referred by the hospital’s clinic.” said ADA President Robert A. Faiella, DMD, MMSc. “This is Action for Dental Health at its best, a community solution that can be replicated by hospitals and dentists nationwide.”

Action for Dental Health: Dentists Making a Difference is a major campaign launched this year by the ADA to address a mounting dental health crisis in America. The campaign comprises multiple initiatives that fall into three general areas:

· Providing care now to people already suffering with untreated disease;

· Strengthening and expanding the public-private safety net to provide more care to more Americans; and

· Bringing dental health education and disease prevention into communities.

“The ADA commends Waldo County General Hospital and the dentists who are supporting its new program,” said Dr. Faiella. “We are committed to helping communities across the country establish similar solutions to move patients out of the emergency room and into the dental chair, the right place to get the right care.”

Learn more about innovative ways dentists are moving patients out of the ER and into the dental chair, including updated information on another Maine program, here.

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About the American Dental Association
The not-for-profit ADA is the nation’s largest dental association, representing 157,000 dentist members. The premier source of oral health information, the ADA has advocated for the public’s health and promoted the art and science of dentistry since 1859. The ADA’s state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The monthly The Journal of the American Dental Association (JADA) is the ADA’s flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA’s consumer website