Dental emergency service

from Wikipedia, the free encyclopedia

The dental emergency service represents the dentists outside of normal office hours. It is aimed specifically at emergencies related to dentistry, oral medicine and maxillofacial medicine . Accordingly, it usually exists separately from the emergency medical service . Like him, he is available for any emergencies and pain cases that are not life-threatening on the one hand and cannot be postponed until the next working day on the other. In life-threatening and urgent situations, the emergency services must be contacted. Home visits by an emergency dentist are rather unusual.

Therapeutic measures in the dental emergency service

First of all, a distinction must be made between a dental on-call service and a dental emergency service. This leads to the distinction between absolute and relative indications for dental work. In accordance with the emergency service regulations of the respective health insurance association, treatment in the emergency dental service should only be limited to the absolutely necessary dental assistance. After using the dental emergency service, the patient should be referred to his family dentist.

Absolute indication

The absolute indications that are to be regarded as emergencies in the narrower sense and that require immediate dental treatment include

In any case, emergency care must avert further complications and enable adequate further treatment on the following day. The restriction of treatment in the sense of emergency care is often justified by the fact that an intervention - especially at night - represents an exceptional situation for the dentist in which he may have to get along without qualified assistance.

Relative indication

Relative indications can be all diseases originating from the dental system with the symptom

General dental problems

Not all types of discomfort a patient experiences are a dental emergency. For example, a broken prosthesis is undoubtedly extremely uncomfortable for the patient because he may be temporarily toothless, but it is not a medical emergency in the narrower sense. A lost filling that does not cause any major discomfort is not an emergency, even if it is in the anterior region can be disturbing. The same applies to a loosened or defective tooth crown .

Organized under public law

The statutory health insurance associations are obliged to organize an emergency dental service due to their security mandate (Section 75 (1) SGB V). All resident dentists have to take part in this emergency dental service on the basis of the professional regulations applicable to them in accordance with the applicable medical professional association laws. The professional regulations are issued by the Dental Associations as public corporations . More details on the emergency service are regulated by the emergency service regulations of the dental associations. In some federal states, the emergency dental service is organized by both bodies together.

There is currently (August 2012) no national emergency number for dental emergencies, but is in preparation. Even within a federal state there is often no standardized telephone number. The dental emergency service of the dentists' chambers and dental associations can usually be reached via individual local landline numbers of these bodies. Usually they switch an answering machine through which the dentists on duty in a city or region are announced. The patient then contacts one of the dentists independently. The local emergency service numbers are usually published in daily newspapers, telephone books, telephone inquiries and the websites of the responsible dental association or the association of statutory dentists. Some of the numbers are also published on independent emergency services websites.

In Thuringia, the emergency dental service has been mediated since July 2018 via the nationwide number 116117 for the medical on-call service. KVT-Notdienst Service gGmbH mediates callers to the dentist on behalf of the Thuringia Association of Statutory Health Insurance Dentists.

A comprehensive emergency service is not available at all times. Especially at night, patients seeking help receive an announcement on the emergency numbers that no emergency service is currently available in their area. The announcement service does not announce the on-call services in neighboring districts.

In 2011, the Bavarian Association of Statutory Health Insurance Dentists was the first KZV in Germany to set up a Bavaria-wide emergency service portal, which provides comprehensive dental emergency services both online and via mobile telephony . The Baden-Württemberg Association of Statutory Health Insurance Dentists has also had an emergency service portal for its four districts since mid-2012. In 2016, the Hessen Association of Statutory Health Insurance Dentists equipped the emergency service card with new functions on its website.

The emergency dental service is available to all patients regardless of their level of insurance.

Organized under private law

In addition to the dental emergency service organized under public law, there are often emergency services organized under private law. As private dental emergency services, some of these are only available to privately insured patients and self-payers, and some as general emergency services, including statutory and uninsured patients. In the latter case, they are comparable to the public emergency services with regard to the offer. Patients with statutory health insurance can use privately organized emergency services to the same extent as public emergency services. The costs for this are covered to the same extent by the health insurance companies .

Remuneration of the emergency service

Cash patients

The service content of Bema No. 03, the billing provision for the emergency service surcharge, reads: "Surcharge for services outside of the consultation hour". The Bema no. 03 can generally be used for emergency treatment, which takes place in the emergency consultation hour officially assigned by the Association of Statutory Health Insurance Dentists, as well as in urgent treatment emergencies outside of the consultation hours, for which the practice operations are started. The surcharge is approx. € 13.70 with minor deviations depending on the federal state.

In addition, the emergency services provided are rewarded according to the cash register fee regulations (BEMA) .

Private patients

In the GOÄ private fee schedule, the surcharge is, depending on the time:

  • A Surcharge for services provided outside of the office hours € 4.08
  • B Surcharge for services rendered between 8 p.m. and 10 p.m. or 6 a.m. and 8 a.m. outside of office hours: € 10.49
  • C Surcharge for services provided between 10 p.m. and 6 a.m. € 18.65
  • D Surcharge for services rendered on Saturdays, Sundays or public holidays € 12.82

In addition, the emergency services provided are rewarded according to the private fee schedule for dentists (GOZ).

criticism

The surcharge items do not by any means cover the additional costs of treatment in the emergency service - especially when treating a single emergency patient. These include a .:

  • the imputed costs of the travel time to and from the practice
  • Travel expenses for round trip
  • Personnel costs of the assistant ( dental assistant )

Problems and dangers in the nightly emergency service

Maintaining an emergency service at night or opening a practice at night for an emergency involves considerable dangers and difficulties. This includes the arrival and departure, especially by dental staff, mostly young women, as no public transport is available at night. Dentists, especially female dentists, in practice rooms that are located in lonely, remote locations, in commercial properties or in the countryside are at risk of being attacked. Aggressive behavior, e.g. B. by drunk patients, cannot be ruled out.

The nocturnal dental emergency service is only visited in rare cases, so that the regular, area-wide provision of a nightly emergency standby is uneconomical. The tendency is therefore to centralize the nocturnal dental emergency service in dental clinics.

Individual evidence

  1. ↑ Scientific statement of the German Society for Dental, Oral and Maxillofacial Medicine (PDF; 30 kB)
  2. ↑ §75 Abs. 1 SGB V.
  3. ↑ Bavarian Medical Professions Act
  4. ↑ Professional Code of the BLZK (PDF; 263 kB)
  5. ^ Emergency service portal of the Bavarian Association of Statutory Health Insurance Dentists
  6. ↑ Dental emergency service. In: kzvbw.de. April 16, 2019, accessed April 16, 2019 .
  7. ↑ [1]
  8. ↑ https://www.kzvh.de/presse/pressearchiv/KZVHO026426.html
  9. ↑ ZMK-aktuell: Explanations for BEMA 03
  10. ↑ Medical costs online

Web links