In 1617 John Woodall published The Surgion’s Mate [sic] which was an instructional manual for young surgeons at sea. In the part about teeth pulling he lamented that some surgeons believe they are too good to be pulling teeth and couldn’t be bothered with it. Woodall didn’t cotton to that as a sailor with a sore tooth didn’t have many options for relief if the surgeon wouldn’t help him.
Back to the OP . . .
Every hospital I’ve worked or trained in (all in Canada) had an active dentistry department. A number of medical conditions require the involvement of dentists - ranging from routine dental care for the severely (mentally) challenged to dealing with oral/dental manifestations of systemic disease (e.g. HIV) to trauma management to gum surgery (e.g. for phenytoin-induced gingival hyperplasia).
Hospitals can and do bill for dental procedures, at least for the facility portion.
When I worked for a large insurance company, I had to deal with such a claim. IIRC, the patient was a child with significant dental problems that were so bad that he had to undergo general anesthesia to repair them all. The dental portion of the policy covered the dentist, but we had to do the go-around to find out how to get the hospital paid, because there was medical reason to do the work there, versus in a dentist’s office.
I also know that my local hospital has a dentist available on retainer to take care of patients who come to the ER with mouth trauma, as well as for untoward incidents involving badly-placed endotracheal tubes and endoscopes, so I’d imagine this to be the case at other hospitals.
Thanks. Great info. Ignorance fought.
The simplest reason is that dentistry and medicine are two different professions, with entirely different training and certification structures in the US.
The hospital medical staff is composed of MDs and DOs (“Physicians” in the US) who are privileged by a structure at the hospital to take care of patients within the governing structures of that hospital. Some hospitals do, in fact, grant staff privileges to dentists, but this is an added component not historically part of inpatient and hospital-based care.
Medicine does encompass oral surgery, and some oral surgeons have DDS degrees in addition to their medical degree and surgical subspecialty training, but in general oral and maxillofacial surgery is somewhat distinct from the sort of routine dental care that can be done as an outpatient.
Much of medicine is driven by various governing systems and regulatory agencies, and to a large extent this tends to drive who practices where. You don’t just walk into a hospital and tell them you will be treating patients there.
In the ED, where I spent my career, we do get a fair amount of patients who come in with dental problems. For the most part, these issues are simpy temporized until an appropriate oral surgery or dental specialty follow up can be made for definitive care. I hope it’s not quite true that we in the ED just give a pain med and send the patient out; there are a number of acute dental problems that can be ameliorated in the ED. For really serious acute problems we do keep a list of dentists prepared to see patients on an emergency basis, but for the most part most non-traumatic dental emergencies can wait til the morning if the pain is treatable with a nerve block or medication.