Dr. Brian Alexander, a dentist in Franklin County, prepares a denture for a patient. Alexander is one of the only dentists in the county who offers pro bono services to the local free clinic. (Katie O'Connor/Virginia Mercury)

By Sarah Bedard Holland

As the 2020 legislative session begins, a recent study from Virginia’s Department of Medical Assistance Services on emergency department use for dental issues among Medicaid recipients shows an unavoidable truth: Virginians are in desperate need of oral health care. 

Under Virginia’s current Medicaid program, adults in Virginia do not have a comprehensive dental benefit. And the governor’s biennial budget did not address this gap in care.

This means oral health care like routine cleanings, or fillings, are not covered by our state’s health program, leaving over half a million adults without access to the care they need to be healthy. Oral health has a direct impact on a person’s overall health. It influences a person’s ability to control their diabetes, heart health and nutrition. It also impacts employment and overall quality of life. We cannot continue to ask Virginians enrolled in Medicaid to try to be healthy without offering a dental benefit that meets their total health needs.

Fortunately, we have an opportunity to correct this longstanding coverage gap during this 2020 legislative session. 

The DMAS study findings also show that Virginia is spending money on an avoidable issue; resources that could be spent preventing dental disease and promoting comprehensive health. The study found in 2018 nearly 16,000 Medicaid recipients visited the emergency department approximately 19,000 times for dental related issues. Of those visits, more than half were for non-traumatic dental conditions like toothaches or loose teeth, and most were for adults who do not have a dental benefit in Medicaid.

This means Virginia is spending money for Medicaid enrollee’s emergency department dental visits, money that would be much better served preventing illness. National studies have shown that the average cost for a Medicaid recipient’s dental care in an emergency room is nearly 10 times more expensive than preventive care from a dentist.

Along with cost savings, a comprehensive adult dental benefit will improve access to care for Virginia’s Medicaid recipients and support the state’s dental safety net which is currently overwhelmed trying to keep up with the need for dental services. Virginians enrolled in Medicaid know that oral health care is important, nearly 1/3 of adults enrolled in Medicaid cited access to dental care as their biggest unmet need. Yet while they recognize the importance of oral health, 50% of Virginians have put off dental care because of cost, and people of color are disproportionally more likely to go without care. It’s time Virginia’s legislators join Medicaid recipients in acknowledging the need for oral health care by adding a comprehensive adult dental benefit that gives Virginians the opportunity to get the cost-effective care they need.

The findings from the DMAS study underscore the importance of adding an adult dental benefit to Virginia’s Medicaid program during this legislative session. Not only will it improve health outcomes for Virginians, but it will also save money for Virginia as well. Improving health while lowering costs is an issue we can all get behind. 

We cannot afford to continue to delay addressing the oral health care needs of Virginians. The longer we wait, the more money is wasted. Virginia Health Catalyst and our partners are advocating for a budget amendment to add a comprehensive adult dental benefit for all adults enrolled in Medicaid during the 2020 legislative session. Join us in our efforts to reduce costs for Virginia and improve the health of our residents.

Sarah Bedard Holland is CEO of Virginia Health Catalyst, formerly the Virginia Oral Health Coalition.