by Camalot Todd, Nevada Current
For the first time in Nevada, Medicaid is expanding dental services to adults with intellectual and developmental disabilities, an expansion made possible by $2.5 million in the American Rescue Plan Act (ARPA) and a Federal Title 19 grant.
Dental clinics do not have to accept patients with disabilities, many dentists do not have the training required to provide care to people with developmental and intellectual disabilities, and low reimbursement rates from Medicaid also hinder dentists from accepting it as insurance, according to a new website, Every Smile Matters, launched by Nevada Medicaid.
In the U.S., Medicaid does not provide uniform dental coverage for those with intellectual and developmental disabilities despite nearly 60% of people with intellectual and developmental disabilities relying on Medicaid for health care coverage including dental care, according to a 2022 National Council on Disability report on oral health care.
Despite oral health being critical to overall physical and emotional well-being, barriers to access lead to health disparities — those with intellectual and developmental disabilities have poorer oral hygiene, higher rates of tooth loss, increased prevalence of periodontal (gum) disease, increased numbers of untreated cavities than the general population, according to the report.
People with intellectual and developmental disabilities can have trouble sitting still during dental visits and may need sedation or general anesthesia. Sedation, along with root canals, preventative care, multiple doctors’ appointments, fillings, and cleaning is not available for them.
Other challenges can include difficulty in being transferred from a wheelchair or being safe/comfortable in a dental chair, filling out paperwork or using certain toothbrushes, translation assistance including sign language interpreters, and behavioral tics or reflexes that could cause injury.
Poor oral health is linked to conditions like diabetes, hypertension, and other cardiovascular, endocrine, and respiratory diseases and oral pain can interfere with eating, sleeping, and communication. It can also result in low self-esteem and altered speech, according to the 2022 National Council report.
Since January, 52 dentists have participated in the program.
“I have seen stress, effort, and cost place a huge burden not only on patients but also on loved ones and caregivers,” Keith Benson, the Nevada State Dental Officer, said in a release. “I applaud the dentists in our state that have stepped up to the challenge to serve this population.”
Nevada Medicaid provides dental services as a mandated service for Medicaid-eligible individuals under 21 as required by the Early and Periodic Screening, Diagnostic and Treatment benefit. Dental coverage is not required for adult Medicaid enrollees, but it is an optional service for emergency care and dentures for those who are eligible over 21 years old, Ky Plaskon, the public information officer for Nevada Medicaid, said.
Adults who are eligible for the new dental coverage can receive up to $2,500 in annual benefits. Those with Medicaid must email their Regional Center Service Coordinator with the Aging and Disability Services Division ([email protected]) who can provide a list of participating Medicaid dentists. Those already a part of the HCBS ID waiver can write to [email protected].
To Apply for Nevada Medicaid visit Access Nevada, or call 1-800-992-0900. Those who are not eligible for Medicaid may be eligible for subsidies and tax credits to cover monthly health insurance costs through NevadaHealthLink.com.