CHATTANOOGA, Tenn. (AP) — The dental health care for Tennesseans ranks among the worst in the nation, which has sent more patients to the emergency room and caused more adults to lose teeth to decay and disease.

A Behavioral Risk Factor Surveillance System survey performed by the U.S. Centers for Disease Control and Prevention showed the number of people who visited a dental clinic or a dentist dropped nearly 10 percent between 2005 and 2010.

The same survey found the number of people who lost at least one permanent tooth increased to nearly 55 percent of the population in Tennessee.

That puts Tennessee at 47th in the nation for dental health, The Chattanooga Times Free Press reported (http://bit.ly/KWf2ji ).

But poor dental health isn't just about teeth. Gum disease has been linked to heart and lung disease, diabetes and low-birth-weight babies.

"Dental decay and infections cause all kinds of problems," said Stan Brock, founder of Knoxville-based Remote Area Medical Volunteer Corps. "We are doing full-mouth extractions for people in their 20s. People don't understand the desperate need for dental care in this country."

Remote Area Medical has held at least 10 free medical clinics in Tennessee this year and anywhere from 50 to 85 percent of the people who come are there for dental care, Brock said.

In rural areas, access to dental care for adults and children can be hard to find. Almost all the counties in the Chattanooga area qualify as federally underserved dental areas, which means they have less than one dentist per 50,000 residents.

Tennessee is one of six states that don't cover dental care for Medicaid enrollees 21 or older. County health departments provide dental care for children, but only emergency dental care for adults.

Dr. Jim Gillcrist, TennCare Dental director, praised the service provided by county health departments and said few states offer similar emergency care.

But Michele Johnson with the Tennessee Justice Center, a nonprofit law and advocacy group, said most low-cost dental clinics have more patients than they can handle, and that doesn't leave a lot of options for people without private dental insurance.

Without preventive care, many people are ending up in emergency rooms due to dental problems. According to the Pew Center, over 53,000 people visited an emergency room for dental care in 2009 in Tennessee. Of those, more than 23,000 visits were for conditions such as cavities and abscesses.

"The study basically shows the system is broken and there are huge unmet needs," said Shelly Gehshan, director of the Pew Children's Dental Campaign.

In Tennessee, 41 percent of preventable ER visits were Medicaid enrollees, while another 41 percent were uninsured. And the average cost of a Medicaid enrollee's inpatient hospital treatment for dental problems is nearly 10 times the cost of preventive care, the Pew study found.

"It's such a colossal waste of money," Gehshan said. "It's just pouring money down a hole."