Governor Cuomo, we have a dental emergency

HON. GOVERNOR CUOMO

First of all, kudos to you, Governor Cuomo for your handling of this dire situation.

We are facing a failure of colossal proportions in dental health. As it should be, the majority of resources are going towards the current crisis managing the Covid-19 outbreak. Yet we cannot ignore dental emergency services and other services which, if not addressed and treated, will become their own emergencies.

If we ignore the issue by merely being reactive and not proactive, in the near term we will be facing significant yet avoidable dental health issues that will, in turn, lead to deleterious effects on overall health.

We need to keep dental emergencies in the dental office and not in the hospitals.

The New York Times reported on March 15 (https://www.nytimes.com/interactive/2020/03/15/business/economy/coronavirus-worker-risk.html) that dentists face the greatest coronavirus risk since we are working in the mouth. We have six offices across Hudson Valley that are open and ready to serve the needs of our patients and their communities. I called eighty (80) offices in Orange County and almost 80% of them are closed and are not even seeing emergencies. Ezras Cholim, an Article 28 facility in Orange County that serves Kiryas Joel, is even closed at this time.

As you and your team are aware hospitals in non-pandemic times are barely equipped to treat dental emergencies and certainly, in these times, cannot properly treat dental patients.

I have called Orange Regional Medical Center and offered to treat their dental patients and, although there are significant needs and interests, there are substantial monetary issues that must be addressed. ORMC was very receptive and I’m continuing to talk with their Chief Medical Officer, Dr Jim Oxley.

Unfortunately, statistics show a crisis in dental care.

The Health Policy Institute of the American Dental Association released statistics that in 2016 show that:

• Approximately 45 out of every 1000 visits to an ER are for dental treatment
• Every 14 seconds on average someone visits an ER for dental conditions
• A total of 2.2 million ER hospital visits were for dental conditions
• 41% of ER visits for dental conditions among adults are paid for by Medicaid
• 68% of ER visits for dental condition among children are paid for by Medicaid

I’m concerned that with the closure of most dental offices, our hospitals are going to be overrun with dental emergencies taking away critical space, time and staff from Covid-19 patients.

In our offices, we have changed our procedures to limit exposure between patients and staff. We only have ONE patient in the office at any given time, notwithstanding that in our offices we have up to 8 examination rooms. Our doctors and support staff use required Personal Protection Equipment (PPE), but our supplies are woefully low. Although not significant, the costs associated with this type of service is astronomical.

We cannot perform a procedure where the reimbursement rate is not even enough to cover the costs of PPE let alone cover overhead especially in times where PPE helps ensure that our dental professionals are safe and do not contract the virus nor spread the virus to other patients.

Third-party administrators of State services like Fidelis, United Healthcare, and Dentaquest are sitting idly because most Dental offices and facilities are closed. There are minimal payments being processed not because there is no need, but because we have been mandated to only treat emergency dental procedures. Therefore, the funds for dental procedures are there and just need to be reallocated to reflect the current need.

Governor, I have reached out to the Department of Health and Hospital administrators. They all have said that their hands are tied.

They cannot adjust reimbursement rates nor provide us with PPE that we need. It is in your hands to keep our most vulnerable population, those being served by Medicaid, with the ability to find treatment for emergency and critical dental conditions.

Ignoring the looming dental treatment crisis will only put further strain on our health care system. Without providing a viable alternative to manage and treat dental conditions, patients will continue to go to hospital emergency rooms utilizing valuable resources, staff and time that could otherwise be used for the treatment of Covid-19 patients.

Dr Marc Faber

CEO of Edge Dental Management

Marcfaber@smilesinoc.com

Owner of 6 dental practices with 15,000 active patients