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Dental A&E attendances

Study reveals multi-million pound price tag of toothache at A&E

Published on: 6 January 2017

A new study reveals the cost of dental patients at A&E could be 10 times official government estimates, costing the NHS millions of pounds.

The British Dental Association (BDA) has said dental patients seeking free care at Accident and Emergency departments could be costing the NHS as much as £18 million, as recently published research suggests the government may be significantly underestimating patient numbers.

Newcastle University’s Centre for Oral Health Research three-year study of patients visiting Newcastle upon Tyne Hospitals NHS Foundation Trust’s A&E department, highlights that patients attending with dental problems are approaching 1% of all attendances.

This figure is 10 times official government estimates, with over half of the attendances identified related to toothache.

Dentist treating patient's teeth

Problems in the care pathways

Dr Justin Durham, National Institute for Health Research Clinician Scientist, Senior Lecturer in Oral Surgery and Orofacial Pain, Newcastle University, and Honorary Consultant at Newcastle upon Tyne Hospitals NHS Foundation Trust, is senior author of the study published in the Journal of Oral Rehabilitation.

He said: “If you experience toothache without significant other symptoms, then heading to a hospital’s A&E department isn’t always necessarily the best option.

“Ensuring that patients are treated in the right place, at the right time, by the right team is essential for both the patient and the wider public, not just to ensure appropriate diagnosis and treatment but also reduce unnecessary care and personal costs.

“This paper, and other recently published data from Newcastle University’s Orofacial pain research team, suggest there are potentially significant problems in the care pathways both for toothache, and also the group of conditions that cause persistent mouth and face pain such as Temporomandibular Disorders and Trigeminal Neuralgia.”

Thousands of patients with dental problems attend A&E

Around 14,500 patients with dental problems attend England’s A&Es according to official statistics. The BDA has estimated that systematic underreporting could conservatively place dental attendees at closer to 135,000 patients per year at an annual cost of nearly £18,000,000 - with more than 95,000 cases of toothache coming in at £12,500,000.

The BDA recently estimated that 600,000 patients a year are seeking treatment from GPs, who like A&E medics are not equipped to treat dental pain. Dentists’ leaders have called on Ministers to show leadership and provide a coherent strategy for oral health, and to stop hitting patients with inflation busting increases in NHS charges.

Henrik Overgaard-Nielsen, Chair of General Dental Practice at the BDA, said: “Ministers keep underestimating how much their indifference to dentistry has knock on effects across the health service. GPs and A&E medics are having to pick up the pieces, while government’s only strategy is to ask our patients to pay more in to plug the funding gap.

“We are seeing patients who need our care pushed towards medical colleagues who aren’t equipped to treat them. As long as government keeps slashing budgets, and ramping up charges we will keep seeing more of the same.”

This study is part of the Newcastle Academic Health Partners, a collaboration involving Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle University, and Northumberland, Tyne and Wear NHS Foundation. This partnership harnesses world-class expertise to ensure patients benefit sooner from new treatments, diagnostics and prevention strategies.


Reference: Dental pain in the medical emergency department: a cross-sectional study. C. C. Currie, S. J. Stone, J. Connolly, J. Durham. doi: 10.1111/joor.12462

Press release adapted with thanks to the British Dental Association.


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