Massachusetts Medical Society: Law Expands Oral Health Services for MassHealth Patients

Law Expands Oral Health Services for MassHealth Patients

Beginning March 1, adult Medicaid patients will be able to see any MassHealth-participating dentist for fillings needed to restore their teeth, thanks to a recent law that reinstates some restorative services, which had been eliminated entirely in 2010. Existing benefits such as diagnostics, preventive, and oral surgery services continue to be available.

Physicians have been confused about where to send their patients for dental care and what services are covered, said Hugh Silk, M.D., a family physician and MMS Oral Health Committee Chair. “Physicians can once again send their adult patients to local dentists who accept MassHealth with confidence that their patients will receive the care they need.”

“MassHealth has been working for years to improve access and at this point, there are approximately 2,300 dental providers participating with MassHealth equating to 95 percent of our members having access to at least two providers within five miles of their home,” said Tracy Chase, executive director for MassHealth at Dentaquest, which administers the MassHealth dental program.

While restorative filling procedures for all teeth will now be fully covered, certain services such as root canals, crowns, and dentures will still not be covered. MassHealth members can seek care for these services at a community health center dental clinic.

Employed adults lose more than 164 million hours of work each year due to oral health problems or dental visits. In the case of diabetics, pregnant women, and patients with heart disease, good oral health can potentially lower blood glucose levels, lower the risk for preterm labor, and decrease oral-systemic inflammation that leads to worsening heart disease, respectively.

Physicians see their patients routinely for preventive visits and periodically for chronic care; these are opportunities to make oral health screening and dental hygiene advice a part of your review of systems and health maintenance advice, said Dr. Silk. “Make it easy for your office system and staff — have oral health handouts that include a list of local dentists who accept MassHealth.”

To find a participating MassHealth dentist, visit and click on “General Public,” or call (800) 207-5019.

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