Family physicians -- particularly those practicing in low-income urban and rural areas -- know all too well that patients experiencing dental emergencies often turn to their primary care physician or the local hospital emergency room for relief.
A report released in late July by the Center for Studying Health System Change reveals that the inability of low-income patients to access dental care is a cause for concern. The report, "Community Efforts to Expand Dental Services for Low-Income People," focuses on 12 nationally representative metropolitan communities around the country and concludes that "dental care is one of the most difficult health care services for low-income people to obtain."
The report cites a variety of factors for the lack of care, including unavailability of dental insurance, limited dental benefits available through public insurance programs and a "lack of dentists willing to serve low-income patients." Family physicians -- particularly those practicing in low-income urban and rural areas -- know all too well that patients experiencing dental emergencies often turn to their primary care physician or the local hospital emergency room for relief.
New research from the University of Bristol shows that admissions for the surgical treatment of dental abscess have doubled in the last ten years despite the fact that these serious infections are preventable with regular dental care. The findings, published in the British Medical Journal today, could reflect a decline of oral health, changes in access to dental treatment or changes in attitudes to dental care.
Recent surveys report improvements in oral health, so an explanation for the increase in hospital admissions is required. The paper suggests it could be linked to changes to dentists' remuneration in the 1990s, which led many to reduce their NHS workload, and a corresponding decline in the number of adults in England registered with an NHS dentist from 23 million in 1994 to approximately 17 million in 2003/04. These changes may have resulted in reductions in the provision of routine dental care and reduced access to emergency dental care and may explain the rise in surgical admissions.
An alternative explanation is that the problem lies with people not seeking dental care, but a recent survey of 5,200 members of the public and 750 dentists, conducted by the Commission for Patient and Public Involvement in Health, found that 22% of people had declined treatment because of high cost, and 84% of dentists felt that their new contract had failed to improve access to NHS services.