Dental Patients in the Emergency Room: Why EDs Struggle and What Works

Last reviewed: October 9, 2026

How big is the problem?

Different organizations count dental ED visits in different ways, so their numbers differ. CDC's national survey estimated an annual average of 1,944,000 ED visits for tooth disorders in 2020–2022. CareQuest Institute estimated 1.8 million ED visits for non-traumatic dental conditions in 2019. Medicaid data show about 487,000 such visits among working-age Medicaid adults in 2019 alone. Every count points the same way: dental problems are a routine part of emergency care.

Why emergency departments are poorly equipped for dental patients

There is usually no dentist on shift

Hospitals staff EDs with emergency physicians, nurses and advanced practice clinicians. Few have a dentist available, so dental problems are handled by clinicians trained for medical emergencies.

The ED cannot provide definitive dental treatment

Most dental pain comes from decay, infection or a cracked tooth. The fix is usually a dental procedure: draining an infection, a filling, root canal treatment or an extraction. EDs rarely have the dental equipment, imaging or staff for these procedures.

Treatment often stops at symptom relief

Without a dentist, ED care usually means pain relief and, sometimes, antibiotics. The underlying problem remains. In one Oregon analysis, 39% of people who visited an ED for dental pain came back once their medication ran out.

"See a dentist" is not a plan for many patients

Many patients have no regular dentist. Adult dental coverage in Medicaid varies by state, and cost keeps many uninsured patients away. A referral list without an appointment often leads nowhere.

Dental visits add pressure to crowded departments

CareQuest Institute reports that most hospitals are not equipped to treat these conditions properly and that the visits strain hospital resources and staff.

The cycle many patients experience

1. A dental problem goes untreated until it becomes painful.
2. The patient goes to the ED, often at night or on a weekend.
3. The ED relieves pain and screens for dangerous infection.
4. The patient leaves without a dental appointment.
5. The pain returns, sometimes as a more serious infection, and so does the patient.

When dental pain is a true emergency

Some dental infections spread into the face, neck and airway and can be life-threatening. These patients belong in the emergency department, and a good dental pathway never delays their care.

What has changed in prescribing

Pain treatment at ED dental visits has shifted away from opioids. CDC data show opioid-only treatment fell from 38.1% to 16.5% of these visits between 2014–2016 and 2020–2022. The American Dental Association's 2019 guideline advises that, for most adults who are not severely immunocompromised, definitive dental treatment, not antibiotics, is the right approach for toothache and localized swelling. Antibiotics are reserved for signs of spreading or systemic infection such as fever or malaise.

This page is educational. It is not prescribing guidance.

What national organizations recommend

Programs that worked

These are local results from programs with different designs and communities. They show what is possible, not what any one hospital should expect. The Calhoun County program wound down after Michigan's Medicaid expansion added a dental benefit that covered most of its patients.

What a strong ED dental pathway includes

• Screening for red-flag symptoms, with immediate emergency escalation
• Pain management that follows current ADA and CDC guidance
• A way to reach a dentist's opinion: onsite, on call or by teledentistry
• A referral that ends in a real appointment, not just a list
• A care coordinator or navigator who follows up
• Help understanding dental coverage, including state Medicaid benefits
• Measurement, so the hospital knows what is working

Where teledentistry fits

Teledentistry can bring a dentist's view to shifts with no dentist, help sort what is urgent, and connect the patient to follow-up. It cannot replace an in-person exam or procedure. ASTDD notes its potential to reduce dental ED visits while the evidence is still developing.

How to start at your hospital

1. Pull your data: count ED visits with dental diagnosis codes (ICD-10-CM K00–K08) over the last year.
2. Map local dental resources: community health centers, dental schools, the local dental society and teledentistry options.
3. Choose a model: referral tickets, an onsite clinic, volunteer dentists, teledentistry or a combination.
4. Put it in writing: many nonprofit hospitals can name dental access in their Community Health Needs Assessment implementation strategy.
5. Pilot and measure: agree on measures before you start.

Frequently asked questions

Sources

1. CDC, NCHS Data Brief 531
2. CareQuest Institute for Oral Health: Recent Trends in Hospital Emergency Department Visits for Non-Traumatic Dental Conditions
3. CMS, Center for Medicaid and CHIP Services: Adult Non-Traumatic Dental Condition ED Visits
4. Association of State and Territorial Dental Directors: Reducing Emergency Department Utilization for Non-Traumatic Dental Conditions (2020)
5. American Dental Association: Emergency Department Referrals
6. American Dental Association: Antibiotics for Dental Pain and Swelling (2019 guideline)
7. AHRQ HCUP: Emergency Dental Visit Costs
8. National Institute of Dental and Craniofacial Research: Oral Health in America (2021)
9. CDC Oral Health to Prevent Pneumonia Toolkit