Star Quinn moved to Kingsport, Tennessee, in 2023, the same year the state started covering dental care for around 600,000 low-income adults enrolled in Medicaid. However, when Quinn chipped a tooth and it became infected, she struggled to find a dentist who would accept her government health coverage and was also taking new patients.
She ended up visiting an emergency room where she received painkillers and antibiotics, but the pain persisted for weeks. Eventually, she paid a dentist $200 to extract the tooth. Years later, Quinn, a 34-year-old mother of four, still has pain when chewing on that side of her mouth. She said that despite her situation, she is still unable to find a dentist nearby.
“You should be able to get dental care,” Quinn said. “Because at the end of the day, dental care is health care.”
Under federal law, states have long been required to provide dental coverage for children enrolled in Medicaid, the government health program for low-income or disabled individuals. However, providing dental coverage for adults is optional for states.
In recent years, several states have expanded Medicaid dental benefits for adults, aiming to improve access to care. But a new study from KFF Health News revealed that fewer than one in four adults on Medicaid visit a dentist at least once a year.
The issue may worsen due to the “One Big Beautiful Bill Act,” signed into law by President Donald Trump in 2023. The law is expected to cut federal Medicaid spending by over $900 billion over the next decade, with states like California losing about $150 billion in federal funds. These cuts could force states to reduce or eliminate dental benefits altogether.
“We will lose all the gains we have made,” said Shillpa Naavaal, a dental policy researcher at Virginia Commonwealth University in Richmond.
Tennessee’s Medicaid program, for example, spent nearly $64 million on dental coverage in 2024, resulting in a 20% drop in dental-related emergency room visits. But under the new law, the state could lose about $7 billion in federal funding over the next decade.
As of last year, 38 states and the District of Columbia offered enhanced dental benefits for adult Medicaid beneficiaries. These states provide benefits such as checkups, X-rays, fillings, crowns, and dentures. However, most other states only offer limited or emergency care, with Alabama being the only state offering no dental coverage for adults.
States that have expanded their coverage report higher usage of dental benefits, though it remains low overall. A report from the American Dental Association (ADA) found that in 2022, no more than one-third of adult Medicaid recipients in any state visited a dentist. In contrast, around 50% to 60% of adults with private dental insurance see a dentist annually.
Nationwide, 41% of dentists reported participating in Medicaid in 2024. While the number of participating dentists remains stable, many limit the number of Medicaid patients they accept, and some refuse to take new Medicaid patients.
Marko Vujicic, the ADA’s chief economist, explained that low reimbursement rates are a major factor discouraging dentists from accepting Medicaid patients.
In southwestern Virginia, the Appalachian Highlands Community Dental Center in Abingdon sees patients who travel over two hours for care. But the center can only treat a fraction of the demand, with around 3,000 people on its year-long waitlist. Elaine Smith, the center’s executive director, noted that while patients can now access dental care, many still don’t have a regular dentist.
“It’s sad because they have the means now to see a dentist, but they still don’t have a dental home,” Smith said.
Additionally, logistical barriers such as lack of transportation, child care, and time off from work prevent many low-income adults from accessing care. The consequences of untreated dental issues go beyond tooth pain; poor dental health is linked to serious health problems like heart disease and diabetes. Furthermore, it can affect a person’s ability to apply for jobs and lead a healthy life.
Robin Mullins, 49, has been on and off Medicaid since 2013. She lost her bottom teeth due to a lack of regular dental care. Living in rural Clintwood, Virginia, she drives nearly 90 minutes to get care at Smith’s clinic. But finding time away from her job as a DoorDash driver and coordinating child care for her daughter, who has special needs, is difficult. She uses partial dentures but misses her natural teeth.
“It’s absolutely horrible, as you can’t chew your food properly,” Mullins said.
Meanwhile, in New Hampshire, the challenge lies not in a shortage of dentists but in the low demand for dental care. Tom Raffio, CEO of Northeast Delta Dental, said the state has increased the number of participating providers and introduced two mobile dental units.
“We just have to overcome a cultural barrier,” Raffio said. Many residents, he explained, are used to going to the emergency room for dental issues rather than visiting a dentist.
In Maryland, dental director Brooks Woodward noted that about one in five adults on Medicaid in the state sees a dentist in 2024, a relatively good number considering enhanced dental benefits only started in 2023.
“Many adults on Medicaid think that dental visits are only for when you’re in pain,” Woodward said.
Related Topics:
- Iowa Dentists Board Puts Coralville Dentist on Probation for Overdiagnosis
- £5M Dental Clinic Opens In Plymouth To Deliver 12,000 NHS Appointments A Year
- VCU Expands Give Kids A Smile Event to Promote Children’s Oral Health Across Richmond
Tags: dental caredenturesdiseaseteethtooth Read More