A Costly Dental Destination

Hospital Care Means States Pay Dearly

A Costly Dental Destination
PDF Downloads

Quick Summary

Already stressed state budgets are shouldering an extra burden to cover expensive emergency room (ER) treatment for toothaches and other avoidable dental ailments, according to a new report by the Pew Center on the States.

A Costly Dental Destination estimates that preventable dental conditions were the primary reason for 830,590 ER visits by Americans in 2009—a 16 percent increase from 2006. Pew concludes that states can reduce hospital visits, strengthen oral health and reduce their costs by making modest investments to improve access to preventive care.

Dental-related hospital visits are fueled by the difficulty that disadvantaged people have getting regular preventive care from dentists and other types of providers. In 2009, 56 percent of Medicaid-enrolled children did not receive dental care—not even a routine exam. The access problem is driven by multiple factors, including a shortage of dentists in many areas of the U.S. and the fact that many dentists do not accept Medicaid-enrolled children.

Key findings  

The cost of ER care can be substantial. For example, in Florida, dental-related, emergency hospital visits produced charges exceeding $88 million in 2010. States are saddled with some of these expenses through Medicaid and other public programs.

“The fact that so many Americans go to hospitals for dental care shows the delivery system is failing,” said Shelly Gehshan, director of the Pew Children’s Dental Campaign. “The care provided in an ER is much more expensive, and it generally doesn’t solve dental problems. Most hospital ERs are not staffed with dentists, and the medical personnel who work there are not trained to treat the underlying problems of patients with untreated dental issues.”  

Although statistics are not available from all states, Pew’s report shares hospital data from 24 showing the frequency and cost of dental-related ER visits, including:

    California: More than 83,000 emergency visits in 2007 for preventable dental problems

    North Carolina: More than 69,000 trips to ERs in 2009 due to teeth or jaw disorders

    Illinois: Nearly 77,000 dental visits to metro Chicago’s hospitals from 2008 to 2011

    Florida: More than 115,000 dental-related ER cases in 2010

    New York: A 32 percent increase in emergency treatments for young children with preventable dental problems


Report Assets

February 28, 2012
Mary McNamara | 202.540.6580
Children's Dental Policy
Children's Health


  • December 10, 2010

    It Takes A Team

    This 2010 report was the first to examine the impact that hiring new types of dental providers—dental therapists and hygienists-therapists—could have on both the productivity and profits of a private dental practice, where more than 90 percent of the nation’s dentists work. 


  • May 28, 2009

    Help Wanted

    This 2009 report looked at how access to dental care has become an increasingly serious problem for many people in the United States, particularly for children.  There is a shortage of private dentists and a limited availability of affordable, or government-supported dental care. This is further compounded by the small number of private dentists willing to participate in public health insurance programs, or treat young children and other underserved populations, especially in rural areas.


  • May 4, 2010

    The Case for Home Visiting

    This 2010 report examined how voluntary home visiting programs match parents with trained professionals to provide information and assistance during pregnancy and throughout their child's first three years. The report found that this support not only helps families thrive, but saves states money on costly social problems.

  • February 12, 2014
    Expanding the Dental Team

    Expanding the Dental Team

    Expanding the Dental Team looks at two private dental practices that employ dental therapists to increase access to dental care for underserved populations. more

  • November 21, 2013

    Growing the Dental Workforce

    This report examines how community colleges and workforce investment boards can help to expand the dental team and improve access to care for millions of Americans. It also offers guidance on how these institutions can cultivate support and leverage existing resources to develop education programs and employment opportunities for midlevel dental practitioners. more