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What You Need to Know about Dental Health Care in California

  • The Surgeon General has reported that oral health problems can cause infection and signal trouble in other parts of the body.
  • Periodontal (gum) disease in pregnant women has been associated with preterm and low birth weight babies, diabetes, cardiovascular disease, stroke, and bacterial pneumonia.
  • Children frequently have poor oral health and, in California, their oral health is substantially below national targets. By third grade tooth decay affects almost two-thirds of California children.
  • Tooth decay is the most common chronic childhood disease — five times more common than asthma and seven times more common than hay fever in 5- to 17-year-olds.
  • Nationally, nearly one in three people over age 65 has untreated dental cavities, and one in four between the ages of 65 and 74 has severe periodontal disease.
  • Left untreated, dental diseases can result in severe pain and infection leading to various health problems, difficulty with the activities of daily living, and in very rare cases, death.
  • Denti-Cal (Medi-Cal’s dental program) covers 8.5 million low-income, elderly, and disabled people in California.
  • While every major medical, dental, and public health organization recommends that children be seen by a dentist by age one, only one in ten children under age 2 who are enrolled in Denti-Cal have had a preventive dental visit.
  • Less than half of dental practices accept Denti-Cal patients, and access to specialty care, such as pediatric dentistry and orthodontics, is very limited.
  • Only one in five pregnant Medi-Cal beneficiaries have had a dental visit. It is widely recognized, however, that sound oral health is essential to the overall health of both mothers and unborn children.

Source: California HealthCare Foundation


Did you know? Denti-Cal covers most dental services:

• Diagnostic and preventive dental services (e.g., examinations, x-rays, and cleanings)

• Emergency treatment for control of pain and infection

• Fillings and tooth extractions

• Root canal treatments

• Prosthetic appliances (e.g., dentures)

• Orthodontics for children who qualify

Expanded Medi-Cal Benefits Improve Lives of Many California Dental Patients
By John Luther, DDS, Chief Dental Officer Dental care benefits under Medi-Cal – and the over 13 million Californians who depend on them – took a big hit in 2009. State budget constraints caused by the onslaught of the Great Recession resulted in deep cuts to state services, including basic dental care under the Medi-Cal program. Eight years later, as the economy slowly recovered, California lawmakers passed a bill that fully reinstated those reduced benefits, providing improved dental care services not previously included as covered benefits under Medi-Cal. The changes took effect January 1, 2018. The Medi-Cal Dental enhancements are substantial. Patients are now covered for procedures like scaling & root planing (SRPs or “deep cleaning”), treatment vital to the management and prevention of gum disease in high risk patients. Root canals on back teeth, instead of extractions, are now a possibility for many. Partial dentures are an option for denture patients. And many other services – exams, x-rays and fillings – are now included. This is good news. For example: It means that, if clinically appropriate, a denture patient doesn’t need a full mouth extraction to receive dentures – previously the only option under Medi-Cal – because partial dentures, which require fewer, if any, extractions, are now covered. Partial dentures not only provide significantly better performance and comfort than full dentures, but they also save existing teeth, help maintain bone and a provide a better quality of life. A patient requiring a root canal on a back molar is now covered for that procedure, saving the tooth and preserving bone and the overall health of the patient. Under previous Medi-Cal coverage, the patient’s only option was extraction. Scaling & root planing, now covered, is critical in controlling gum disease. Untreated gum disease makes it harder to control diabetes and is linked to other diseases such as heart disease, respiratory diseases, and even cancer. It’s been gratifying to see significantly more patients now enjoying this enhanced quality of dental care coverage. At the 191 Western Dental offices in California, we’ve seen an increase of 20% in Medi-Cal Dental patient visits since the beginning of the year. Being the largest provider of Medi-Cal Dental services in the state, we’re geared up to meet this pent-up demand. Our doctors and staff have been preparing for months in anticipation of the influx, and we expect to see a continued flow of new and returning patients as more patients with Medi-Cal Dental learn of their enhanced benefits.
How to Get the Most from Your Dental Plan
  Going to the dentist is probably the last thing on your mind this holiday season. But while you’re making your to-do list, you might add “make dentist appointment” because December is an ideal time for a visit. Kids are out of school for their holiday break, appointment slots are available, and for many of us, dental plan benefits expire at the end of the year.  That makes getting in to see the dentist a higher priority this month.   If you’re in the middle of dental treatment, it can be important to make that next visit. For example, as patients receiving a dental implant know, there are several steps to receiving your implant. If your last appointment was for bone restoration a few months ago, you may be ready for placement of the implant. Or the doctor may have your permanent crown ready to replace that temporary crown you received a few weeks ago.   Scheduling a cleaning with the hygienist is wise every six months, and more often if you had periodontal care on your last visit. Coming in for an appointment now to continue treatment you’ve started means you can use up deductibles and maximize your plan’s benefits this year.   You may also want to start needed treatment with any remaining benefits you may have this year, and then pick up where you left off with fresh new benefits in January. Many people split care over two year’s benefits this way for best coverage.   Don’t neglect your oral health altogether this holiday season. Squeeze in an hour of your day to see your dentist just one more time before year end.  You’ll know you’re getting the most out of your dental plan, and you’ll feel good about starting off the New Year with a fresh new smile!