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Adult dental benefit moves closer to reality in Maryland

April 21, 2017

By David Burger

Photo of Dr. Romaine
Dr. Romaine
Annapolis, Md.
— Maryland residents are one step closer to having an adult dental benefit through the Maryland Medical Assistance Program, also known as Medicaid.

The Maryland General Assembly gave unanimous and bipartisan final approval April 10 to Senate Bill 169, legislation that could lead to the establishment of an adult dental benefit.

The bill is headed to the governor’s desk for signature in the near future.

"This was a truly bipartisan team effort,” said state Delegate Mike McKay in a news release. His floor amendments to Senate Bill 169 adopted language from House Bill 1158 and potentially authorizes the expansion of Medicaid to adult dental services.

"I think Maryland has turned a corner and finally recognizes the serious and irreparable health consequences of poor oral health,” Delegate McKay said. “This legislation puts us on track to include an adult dental benefit in Medicaid. Too many people are suffering and living in chronic pain needlessly. By putting oral health on the front burner we have helped put a smile on the face of thousands of Marylanders.”

The legislation requests that the Maryland Dental Action Coalition study the cost to Medicaid for emergency room visits by adults with chronic dental health conditions. The study, due Dec. 1, may also consider whether it is advisable to expand Medicaid benefits to include dental services for certain adult Medicaid enrollees.

If the governor signs SB 169 and the Maryland Dental Action Coalition study concludes that expanding dental benefits in Medicaid to include dental services for adults with income at or below 133 percent of poverty is advisable, the state may provide dental services for this population beginning Jan. 1, 2019, subject to budgetary constraints.

“We can’t afford not to do it,” said Dr. Diane Romaine, past president of the Maryland State Dental Association and president of the Maryland State Dental Association Charitable & Education Foundation. “This is a vote of support. We’re hopeful and very inspired that we’ve come this far.”

Dr. Romaine said that a Maryland study after the 2014 fiscal year showed that the cost savings of adding a Medicaid adult dental benefit were significant. The study, published in a research brief by the ADA Health Policy Institute in late 2014, showed that a “Medicaid program could save up to $4 million per year by diverting emergency department dental visits to dental offices where more appropriate and more cost-effective care can be provided.”

According to Medicaid.gov, states are required to provide dental benefits to children covered by Medicaid and the Children's Health Insurance Program, but states choose whether to provide dental benefits for adults.

Currently, Maryland Medicaid does not cover dental services for adults 21 years or older, except for pregnant women, individuals enrolled in the Rare and Expensive Case Management and emergency services for dental problems provided in a hospital emergency department, according to a February 2016 report conducted by the Hilltop Institute, a nonpartisan health research organization.

In Maryland, “Medicaid dental benefits for adults in emergency rooms are limited to palliative care through pain medication and antibiotics, not definitive restorative and preventive care,” Dr. Romaine said.

“Expanding Medicaid to include an adult dental benefit is the right thing to do,” said Salliann Alborn, chair of the Maryland Dental Action Coalition, in a news release. “Uninsured adults have virtually no access to care and as a result, we see increased emergency room visits and related systemic illnesses that can often have life-threatening consequences. Together, we will raise the bar to improve access to oral health care like many other states have already done for their citizens.”