Policy Statement on Reinstatement of MO HealthNet Adult Dental Benefits

November 15, 2013

The Missouri Coalition for Oral Health Supports the Reinstatement of MO HealthNet Dental Benefits for Adults

The Missouri Coalition for Oral Health has identified the reinstatement of adult dental benefits for MO HealthNet (Missouri Medicaid) as a top policy priority. Reinstatement of MO HealthNet dental benefits for all adults who quality for MO HealthNet is needed to ensure the overall health of MO HealthNet recipients.[i] Covering routine, preventive oral health care and comprehensive dental treatment for MO HealthNet adults is cost-effective. This will also reduce the use of expensive emergency room and hospitalization services for untreated oral disease and disorders that could have be easily and better managed through routine dental care.

Oral Health is a key part of overall health. Sound public policy in support of a system of care is needed to ensure that improvement in the oral health of Missourians is achieved and maintained over time. Coverage of adult dental services for MO HealthNet recipients is a key aspect of a system of services and supports to ensure the health of Missourians. Coverage of adult dental will support the efforts of dental professionals throughout Missouri to provide appropriate and timely oral health care.

The lack of routine, preventive oral health care and comprehensive dental care creates inefficiencies in the overall health care system and encourages the use of costly alternatives. When Americans delay treatment for oral health issues, preventable issues often become complicated ones before treatment takes place. A recent retrospective analysis found a dramatic increase in hospitalizations from 2000 through 2008 for dental infections and found more than 61,000 cases and a growing problem.[ii] The number of hospitalizations for treatment of dental abscesses increased 41% from 2000 to 2008.

The most recent national data available also indicates a dramatic increase in the use of emergency rooms for the purpose of seeking relief of untreated dental conditions.[iii] In Missouri we have seen a similar trend. Between 1994 and 2011 there was a 368% increase in emergency room visit rates for dental complaints.[iv] In 2011, there were 58,714 emergency department visits among Missouri residents for dental complaints. The majority of these visits occurred among adults between the ages of 18 and 64 years of age.[v] Missouri dental emergency department visits in 2011 are estimated to have cost over $17.6 million.[vi] While emergency rooms can provide medication to ameliorate infection and the pain associated with untreated dental disease and conditions, emergency rooms are not equipped to provide dental care.

Comprehensive oral health care is often difficult to afford, particularly for young adults. This contributes to increased use of emergency rooms for dental care.[vii] Use of emergency rooms is insufficient for the treatment of dental conditions.

Reinstatement of dental benefits for all adult Medicaid recipients in Missouri will build a more efficient Medicaid system in Missouri and help ensure that adults are ready to work free of the pain and discomfort of untreated oral disease.

[i] Coverage for adults in MO Medicaid prior to 2005 included dental preventive and treatment services (orthodontics for adults not included).

[ii] U.S. sees alarming rise in dental infection hospitalizations, http://www.drbicuspid.com/index.aspx?sec=def&sub=pre&itemid=314176&wf=37, accessed 9/9/13

[iii] Dental Emergency Department Visits Increase, Medscape, http://www.medscape.com/viewarticle/805242, accessed 9/16/13

[iv] Missouri Department of Health and Senior Services, Oral Health Fact Sheet: Emergency Department Utilization for Dental Complaints, Missouri 1994 – 2011, http://health.mo.gov/living/families/oralhealth/pdf/EmergencyDepartmentUtilizationforDentalComplaints.pdf

[v] Missouri Department of Health and Senior Services, Missouri Information for Community Assessment, MICA. Health.mo.gov/MICA, Accessed November 14, 2013, MICA data

[vi] Missouri Department of Health and Senior Services, Oral Health Fact Sheet: Emergency Department Utilization for Dental Complaints, Missouri 1994 – 2011, http://health.mo.gov/living/families/oralhealth/pdf/EmergencyDepartmentUtilizationforDentalComplaints.pdf

[vii] A Costly Dental Destination, Pew Charitable Trusts, accessed 9/16/13, http://www.pewstates.org/uploadedFiles/PCS_Assets/2012/A%20Costly%20Dental%20Destination(1).pdf