Increase Adult Dental Benefits to Improve Outcomes, Lower Costs

Medicaid and Medicare dental benefits are often limited, which means adults with lower incomes and older adults get dental care less frequently than they should. There’s a ripple effect from untreated oral disease. Pain and dysfunction can lead to tooth loss, complex chronic diseases, hospital visits, and employment issues.  

As outlined in Reversible Decay: Oral Health is a Public Health Problem We Can Solve, a focus on improving medical-dental integration, expanding public benefits and other solutions can help address these access issues.
 

Americans overwhelmingly support expanding oral health access through Medicaid and Medicare. 

Most Americans are unsure or incorrectly believe Medicaid (74%) and Medicare (62%) already cover dental treatment. Regardless of their understanding, 78% of respondents support Medicaid dental coverage and 80% support Medicare dental coverage.   

 

Should These Programs
Include Dental Benefits?

(among all patients)​

78 and 80 percent pie charts
 

What’s more, experts indicate comprehensive dental coverage will help prevent diseases related to untreated oral health issues, improve overall population health, and bend the cost curve related to avoidable emergency dental care and chronic disease management.

infographic
How Could Cutting Adult Benefits Hurt States?
A new infographic from the DentaQuest Partnership provides several examples of how cutting Medicaid adult dental benefits could harm job growth and increase costs in states across the country.
View infographic »
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blog
Advocates Fear Cuts to Medicaid Adult Dental Benefits
With echoes of the 2008 recession and states facing significant budget shortfalls due to COVID-19, many advocates are concerned that the Medicaid adult dental benefit could be at risk.
Read post »
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Webinar
State Advocacy Approaches to Expanding and Protecting Medicaid Adult Dental Benefits
This webinar highlighted strategies, tactics and tools that advocates across the country can use to protect and expand Medicaid adult dental benefits in their state.
View webinar »

 

Most Important Benefits of
Comprehensive Dental Coverage Under Medicaid

(among Medicaid Dental Administrators)

68%  Prevents development of diseases related to untreated oral health issues
59%  Improves the health of the state population
59%  Leads to savings on emergency care
56%  Leads to savings on chronic disease management
34%  Improved oral health allows individuals to find and maintain jobs
17%  Cost-effective for the state's budget

 

Despite the overwhelming agreement those reliant on Medicaid and Medicare should have dental coverage, there is no mandate to include the treatment of dental disease.  

Coverage for adults under Medicaid varies from state to state, and those adult Medicaid dental benefits are often the first targeted for state budget cuts, especially in difficult economic times. As it stands, 68% of Medicaid state dental directors do not think their state programs adequately budget for oral health care. When asked whether they believe the current funding in their state is adequate, 68% of Medicaid dental administrators disagreed.
 

"Medicaid Dental Funding in My State is Adequate."
(among Medicaid Administrators)

 
pie chart     7% Strongly agree
    12% Somewhat agree
    15% Neither agree nor disagree
    22% Somewhat disagree
    44% Strongly disagree 


 

Medicare, meanwhile, is a federal program without mandated coverage for the treatment of dental disease. But recent developments such as The Lower Drug Costs Now Act indicate a shift in the national discourse about oral health. If passed into law, about half of the $456 billion in savings achieved by lowering drug costs over the next decade would instead fund expanding Medicare benefits to include dental coverage, according to the Congressional Budget Office.  

The lack of dental insurance coverage means adults continue to struggle to stay healthy, while states and the federal government continue to rack up avoidable costs. Providing, or expanding, adult dental coverage can lead the way to reducing costs for patients, dentists and states, as well as lowering the incidence of diabetes and other diseases and improving overall health outcomes.