It's a busy Friday morning at Gulf Coast Dental Outreach in Tarpon Springs and Jesse Seabolt is about to have two wisdom teeth removed from the right side of his mouth.
Volunteer dentist Vivian Deluca plays country music as she pops out the first tooth with ease.
"That one's a girl!” she cheers.
Before they found this clinic, Seabolt and his wife, Trisha, used the emergency room when faced with severe mouth pain.
"We're both employed but we make minimum wage so we really can't afford good dental insurance.” Seabolt said. “So this place is a blessing for us."
In 2014, Floridians visited the emergency room 165,000 times for tooth pain, racking up a whopping $234 million. Click here for a county-by-county breakdown of visits and costs.
The Florida Dental Association says many of these visits could have been avoided with preventative care like annual exams and teeth cleanings. But many of these patients can't afford to see a dentist, so like Seabolt , they deal with the pain until it’s too much to handle.
"You get a lot of good services at an emergency room but the one thing they don't usually have is a dentist,” said Harry Gross, outgoing executive director of Gulf Coast Dental Outreach.
He said emergency rooms are just not equipped to handle procedures like fillings, root canals and extractions.
“Typically, they (ER doctors) might give them something for the pain, they'll give some antibiotics,” Gross said. “They go home, the antibiotics help, but because it didn't get to the base problem. The tooth is still there, the problem still there. It comes back."
Dr. Zack Kalrickal, a dentist in Wesley Chapel, volunteers at clinics like this one. He said patients at these clinics pay what they can, but it's a lot cheaper than what they'd pay at an ER.
"I've treated a patient for an extraction for free at a volunteer clinic who had just been in the hospital for three days with I.V. antibiotics,” Kalarickal said. “I can only imagine that bill was over $10,000. I'm sure that bill never got paid at the hospital."
The clinic borrows the Pinellas County Health Department’s dental clinic on Fridays. Unlike pop-up clinics that help address one-time issues like cavities and extractions, this clinic works with patients to create a dental home for people who would otherwise end up in the emergency room.
According to the Kaiser Family Foundation, 27 percent of adults age 20 to 64 have untreated dental issues, and 44 percent of that age group are adults with income below 100 percent of the federal poverty lines.
Twenty-five miles north is the Premiere Community HealthCare dental clinic in Spring Hill. Jeff Pafford is getting x-rays to see how much damage a cracked tooth has caused.
He’s on disability because of his seizures, and can't afford a private dentist.
"If this program wasn't here, I don't know what I would do,” Pafford said.
While he does qualify for Medicaid, dental care coverage is limited. The state only helps pay for emergency services related to injuries, trauma, and extractions – and a limited amount toward dentures, according the Agency for Health Care Administration.
Without this clinic, Pafford said, “I would be in a lot of pain and I probably would end up in the hospital."
According to a 2015 report from the American Dental Association, the number of emergency department visits for dental conditions in the United States continues to rise. In 2012, those visits cost U.S. health care system $1.6 billion.
For hospitals, this is an expensive reality. Florida Blue, the state's largest insurance company, reports that patients pay an average of $749 just for an outpatient visit to the ER for oral care. If patients can't pay that, hospitals shift the cost to people who can.
Hospitals know the care they give dental patients is a Band-Aid solution, and that's why some are partnering with dental clinics.
Cheryl Pollock, spokeswoman for Premiere Community HealthCare, said they pay to have a counselor at hospital chains like BayCare and HCA who refers people dealing with dental emergencies.
"If we can provide care in a small, personalized clinic like ours for a tenth of the cost of an emergency room then that's what we're going to do, “ Pollock said. “The hospitals that we work with love us."
That way, everyone wins. Hospitals lower their costs, and patients get the dental care they need.