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ADA urges governor of Puerto Rico to reconsider defining dental benefits as ‘optional’

March 13, 2017

By Jennifer Garvin

San Juan, P.R. — The ADA has asked Puerto Rico Gov. Ricardo Rosselló to reconsider defining dental benefits as “optional” within the Medicaid program.

“It has been the experience of many states that have tried to reduce health care costs by cutting back on dental Medicaid coverage that such an approach is likely to result in additional health care expenditures in the long run because those uninsured individuals seek care in hospital emergency rooms,” wrote ADA President Gary L. Roberts in a letter to Gov. Rosselló. “Visits to the ER for dental pain are costly and can range from $400 to $1,500 compared to a $90 to $200 visit to a dentist.”

To illustrate this point, Dr. Roberts cited California’s struggle when that state’s Medicaid program in 2009 eliminated its comprehensive adult dental coverage as a result of budget constraints. The impact of this policy change led to “a significant and immediate increase in dental services costs with more than 1,800 additional dental ER visits per year,” wrote Dr. Roberts, adding that the average yearly costs associated with dental ER visits in California increased by 68 percent.

“Hospitals cannot provide definitive care to address dental disease, resulting in patients visiting the ER multiple times for the same problem,” Dr. Roberts said.

“The importance of oral health to overall health status cannot be overestimated,” Dr. Roberts concluded. “In the management of chronic diseases, such as diabetes, elimination of dental services can lead to higher medical costs.

“We respectfully urge you to reconsider this decision which can lead to unfortunate health outcomes accompanied by lengthier and more costly care.”