While it’s fair to say that no one likes having dental work done, for many, the problem goes beyond cringing at the sound of a drill. Certain populations – including young children, the elderly, and individuals with intellectual or developmental disabilities or other special needs – may not be able to cooperate during dental treatment. In these circumstances, having a dental procedure – from a tooth extraction to a root canal – can be terrifying and traumatic for the patient. It can also be difficult, or even dangerous, for dental providers who are manipulating sharp tools inside the mouths of panicked individuals.
To date, the solution to this problem has been to perform dental procedures on certain patients in a hospital operating room, where they can be placed under general anesthesia. This solution enables providers to help people who need dental work, many of whom are in constant dental pain, without causing the patients distress or endangering themselves. However, changes to hospital policies resulting from profit-driven motivations have put in-hospital dental procedures out of reach for patients and dental providers alike. There are several factors at play in this shift:
- Dental procedures are reimbursed at rates significantly lower than those of other surgical procedures, which means that dental procedures are much less profitable for hospitals.
- Even in facilities that nominally allow dental procedures in the operating room, dental procedures are often “bumped” – rescheduled at the last minute – in favor of more profitable surgeries.
- Because they are less profitable, many hospitals do not allow dental procedures to be performed in their operating rooms. And many of the hospitals that did allow dental procedures in the operating room have stopped doing so in recent years.
As a result of these profit-driven decisions by hospitals, vulnerable patients are left in agonizing pain indefinitely as the treatment they need is delayed because an operating room is not available.
Moreover, because dental procedures are only performed at a few hospitals, patients face major access challenges. In California, for example, there are tens of thousands of special needs people who need general anesthesia for dental procedures – but there are only 14 centers in the state that offer operating room space for them. In Kentucky, patients and providers in some areas have to drive upwards of 100 miles each way for a hospital-based procedure. This inconveniences providers and patients alike, creating further barriers to access.