Dental Care as an Essential Benefit

When times are tough and people tighten their belts and family budgets, visits to doctors and dentists often get cut. Even relatively small co-pays can be justification to skip a check-up, renew a prescription, get an annual dental cleaning, or even get a small cavity filled. Unfortunately, ignoring routine care can have serious consequences.

Many States are facing budget challenges as well. As legislatures work to close shortfalls in state budgets, dental benefits provided through Medicaid are being cut or eliminated. This year, California, Hawaii, Massachusetts, Michigan, North Carolina, and Washington have considered funding cuts to, or elimination of, dental benefits. The numbers are significant –California stands to save about $614 million per year. Massachusetts hoped to save $60 million a year, but a recent upturn in revenue has put proposed cuts on hold. That is positive news for Massachusetts because the impact of the proposed cuts would have been staggering. The Massachusetts Medicaid program provides dental services to more than 1 million of the state's low-income seniors, chronically ill, and people with disabilities. That is almost one in ten of the state's neediest residents.

There's a great misconception that dental care is not one of the essential types of health care that people need. Not true. Dental care is critical to everyone’s good health and wellbeing. According to the U.S. Department of Health and Human Services and the American Dietetic Association, a variety of medical conditions – such as diabetes, heart disease, HIV, and complications of pregnancy—have been associated with poor oral health.

When states are forced to make cuts in Medicaid-sponsored dental programs, there are consequences. One is an increase in the numbers of patients with illnesses that could have easily been prevented. Fixing a chipped tooth right away, or filling a cavity when it is small is simpler, less painful, and less costly than waiting for the issue to escalate to a larger, more complicated dental infection. A second consequence is an increase in emergency room and other triage costs -- which taxpayers ultimately pay for -- as patients desperate to relieve mouth pain are left with no other options for care. When an individual visits the emergency room because of mouth pain, the pain may be addressed, but the cause of the problem is often not treated. This leaves the patient vulnerable to more severe problems, which ultimately become more costly to treat.

These are facts. Dental disease is nearly 100% preventable. Dental benefits help people get the care they need in good times and in tough times. Making sure dental care is an essential benefit in state Medicaid programs makes good sense.

Guest Blog Post by Steve Pollock, President of DentaQuest Government Business