Toothache piling the pressure on A&E

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Have you ever wondered how many patients are heading to A&E with dental problems? Well it turns out Health Ministers are not the ones to ask.

Thanks to the team at Newcastle University’s Centre for Oral Health Research we now know that official figures could be under-estimating the number of attendees by a factor of 10.

Their three-year study is revealing a systematic under-reporting of dental problems. The official government stats suggest dental attenders could be as low as 14,000 per year – or 0.08% of all A&E visits in England. The experience of Newcastle points to a figure 10 times that – a conservative estimate of 130,000 or 0.7% of all A&E visits could be the result of dental problems, the lion’s share of which are related to toothache.

Why does any of this matter? Well, patients in dental pain should get the care they need at the right time, in the right place, and from the right people. And it’s the view of Newcastle academics that the overwhelming majority of these patients would have been better off seeking help in primary care, particularly the significant number who have delayed treatment.

And this also matters because of the strain it puts on our NHS. At this scale, we’re looking at £18 million spent on problems that could have been managed at a fraction of the cost at high street practices. Our medical colleagues, who are unequipped to deal with these dental problems, are being left to pick up the pieces.

This is what you get when Ministers offer nothing resembling a strategy for oral health, short of cutting budgets and expecting patients to plug the funding gap through ever-increasing NHS charges.

The casual indifference to dentistry from successive governments is putting pressure on every part of the health system, and it comes with a multimillion pound price tag. We shouldn’t be looking at 600,000 people seeking help at the GP with dental problems every year, or indeed nearly 40,000 children lining up for multiple tooth extractions in hospitals.

We’ve now written to England’s Chief Dental Officer, Sara Hurley, to ask for more emergency slots for dentistry. We’ve suggested this could address the CDO’s concerns about the need for a long-term solution to improve access to urgent dental care, as well as reducing costs for A&E and GP attendances for dental problems.

Our letter points out that if the BDA’s proposal was adopted, it would also have the benefit of providing a clear indication to NHS 111 which dental practices have the availability and capacity to treat patients who need urgent care.

Henrik Overgaard-Nielsen is Chair of the BDA’s General Dental Practice Committee

 

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