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Many emergency room patients have dental problems

| Saturday, April 12, 2014, 8:01 p.m.

ERIE — It's a scene that plays out every day in UPMC Hamot's emergency department.

A patient walks in with severe dental problems, perhaps numerous cavities and an abscess. The person can't eat, and it hurts just to talk and breathe.

“I can't tell you how many times a day we see these patients,” said Ferdinando Mirarchi, D.O., Hamot's director of emergency medicine. “Some days it's one patient. Other days, it can be 20.”

A study published on April 1 in the Journal of the American Dental Association reported that 1 percent of emergency-room visits nationwide from 2008 to 2010 included a diagnosis of dental injury or disease. One hundred one of those patients died while in the ER.

Many of those patients with dental diseases could have been treated at an earlier, less serious and less expensive stage by a dentist. But they refused, or couldn't afford, to visit one.

“Access to dental care is a real problem in this area,” said David Shapter, an Erie pediatric dentist. “There aren't many specialists, such as oral surgeons, endodontists and pediatric dentists, who accept Medical Assistance.”

So the patient waits until the dental problem gets so severe that they head to an ER, which are required by law to treat any patient regardless of ability to pay. But they aren't equipped to deal with most dental emergencies, Mirarchi said.

“Our treatments are limited,” Mirarchi said. “We can prescribe antibiotics and drain an abscess, but we aren't trained to pull teeth (or) trained to treat an extensive abscess.”

Eventually, the antibiotics run out, the infection returns and sometimes a life-threatening complication develops, Shapter said.

“The infection can spread to the brain or go where antibiotics no longer help,” Shapter said.

“Our ER gets backed up with patients seeking dental treatment,” said Silvia Ferretti, D.O., provost of LECOM, which is part of the Millcreek Health System along with Millcreek Community Hospital. “Our goal is that it won't be in the future because those patients can get treated at this clinic.”

Local dentists don't see the clinic as competition, but as a valuable community resource, Shapter said.

“I don't think dentists fear losing patients to the clinic,” Shapter said. “It will be a tremendous release valve for all these patients who can't get access to a dentist.”

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