Phil Galewitz, KFF Health News
Star Quinn moved to Kingsport, Tennessee, in 2023, the identical yr the state started protecting dental prices for about 600,000 low-income adults enrolled in Medicaid.
But when Quinn chipped a tooth and it turned contaminated, she couldn’t discover a dentist close to her house who would settle for her authorities well being protection and was taking new sufferers.
She went to an emergency room, receiving painkillers and antibiotics, however she remained in agonizing ache weeks later and paid a dentist $200 to extract the tooth.
Years later, it nonetheless hurts to chew on that aspect, she mentioned, however Quinn — a 34-year-old who has 4 youngsters and, together with her husband, earns about $30,000 a yr — nonetheless can’t discover a dentist close by.
“You should be able to get dental care,” she mentioned, “because at the end of the day dental care is health care.”
The federal authorities has lengthy required states to supply dental protection for youngsters enrolled in Medicaid, the joint state-federal well being program for people who find themselves low-income or disabled. Paying for adults’ dental care, although, is elective for states.
In current years, a number of states have opted to broaden the protection provided by their Medicaid packages, looking for to spice up entry in recognition of its significance to total well being. So far, rising grownup dental care is a piece in progress: In a sampling of six of these states by KFF Health News, fewer than 1 in 4 adults on Medicaid see a dentist a minimum of every year.
But beneath congressional Republicans’ One Big Beautiful Bill Act, which President Donald Trump signed into legislation final yr, the federal authorities is anticipated to scale back Medicaid spending by greater than $900 billion over the following decade. The expected 10-year losses for individual states vary from about $184 million for Wyoming to about $150 billion for California.
State Medicaid packages sometimes broaden or scale back advantages relying on their funds, and such large federal cuts may power some to shrink or remove what they provide, together with dental advantages.
“We will lose all the gains we have made,” mentioned Shillpa Naavaal, a dental coverage researcher at Virginia Commonwealth University in Richmond.
Tennessee’s Medicaid program, as an example, spent almost $64 million on its dental protection in 2024 and noticed a 20% lower in dental-related ER visits, mentioned Amy Lawrence, this system’s spokesperson.
But beneath the brand new legislation, Tennessee is projected to lose about $7 billion in federal funding over the following decade.
As of final yr, 38 states and the District of Columbia provided enhanced dental advantages for grownup Medicaid beneficiaries, in keeping with the American Dental Association. Most of the others supply restricted or emergency-only care. Alabama is the one state that provides no dental protection for grownup beneficiaries.
Since 2021, 18 states have enhanced their protection to incorporate checkups, X-rays, fillings, crowns, and dentures, whereas loosening annual greenback caps for advantages.
Use of dental advantages in states with the improved advantages is bigger than in states with solely restricted or emergency protection, although nonetheless low total, in keeping with an ADA report with the most recent knowledge as of December. No greater than a 3rd of grownup Medicaid recipients noticed a dentist in 2022 in any state.
To overview more moderen progress, KFF Health News requested one-third of the states which have expanded their advantages previously 5 years for his or her most up-to-date knowledge on the share of adults on Medicaid who go to a dentist a minimum of every year:
Maryland — 22% (in 2024)
Oklahoma — 16% (in 2025)
Maine — 13% (in 2025)
New Hampshire — 19% (in 2025)
Tennessee — 16% (in 2024)
Virginia — 21% (in 2025)
In comparability, about 50% to 60% of adults with non-public dental protection see a dentist a minimum of every year, in keeping with the ADA.
Nationwide, 41% of dentists reported taking part in Medicaid in 2024, a share that has remained secure over the previous decade regardless of the dental profit expansions in lots of states, the ADA says. Many taking part dentists, although, restrict the variety of Medicaid enrollees they deal with, and a few is not going to settle for new sufferers on Medicaid.
Reimbursement charges haven’t saved up with prices, deterring dentists from accepting Medicaid, mentioned Marko Vujicic, chief economist and vp on the ADA Health Policy Institute.
Because of a scarcity of dentists who take Medicaid in southwestern Virginia, the Appalachian Highlands Community Dental Center in Abingdon sees sufferers who journey greater than two hours for care — and should flip many away, mentioned Elaine Smith, its govt director.
The heart’s seven residents handled about 5,000 sufferers final yr, most of them on Medicaid. About 3,000 persons are on its waitlist, ready as much as a yr to be seen.
“It’s sad because they have the means now to see a dentist, but they still don’t have a dental home,” Smith mentioned.
Low-income adults face different limitations to dental care, together with a scarcity of transportation, youngster care, or day off work, she mentioned.
The lack of ability to see a dentist has penalties broader than tooth ache. Poor dental well being can contribute to a number of different vital well being issues, corresponding to coronary heart illness and diabetes. It may make it more durable to do issues like apply for jobs and customarily lead a wholesome life.
Robin Mullins, 49, who has been on and off Medicaid since 2013, mentioned a scarcity of normal dental visits contributed to her shedding her backside tooth. Unable to discover a dentist close to her house in rural Clintwood, Virginia, she drives nearly 90 minutes to Smith’s clinic — that’s, when she will be able to afford to get time away from driving for DoorDash or discover assist watching her daughter, who has particular wants.
She will get by with partial dentures however misses her pure tooth, she mentioned. “It’s absolutely horrible, as you can’t chew your food properly.”
In New Hampshire, although, the challenges have extra to do with low demand than a low provide of dentists, mentioned Tom Raffio, chief govt of Northeast Delta Dental, which manages the state’s Medicaid dental program. The firm has added new dentists to its listing of taking part suppliers, together with two cell dental items that traverse the state, he mentioned.
Raffio mentioned Northeast Delta Dental additionally has publicized the state advantages utilizing radio promoting and social media, amongst different efforts.
Until 2023, New Hampshire Medicaid lined solely dental emergencies.
“Culturally, it’s going to take a while,” he mentioned, “as people just are used to not going to the dentist, or going to the ER when have dental pain.”
Brooks Woodward, dental director at Baltimore-based Chase Brexton Health Care, known as Maryland’s charge of roughly 1 in 5 adults on Medicaid seeing a dentist in 2024 “pretty good” contemplating the advantages had been enhanced solely since 2023.
Woodward mentioned many adults on Medicaid consider that you simply go to a dentist solely once you’re in ache. “They’ve always just not gone to the dentist, and that’s just the way they had it in their life,” he mentioned.
