- Associated Press - Monday, November 9, 2015

CONCORD, N.H. (AP) - New Hampshire lawmakers should consider adding comprehensive dental benefits to the state’s Medicaid program for adults, according to a bipartisan commission created last year to analyze barriers to oral health care.

The commission, which released its report Monday, found that the state does well on some measures, such as having the lowest percentage of third-graders with untreated tooth decay, but did worse on others. For example, about a quarter of New Hampshire adults haven’t visited a dentist in the last year, and accessing dental care is particularly challenging for low-income families in the sparsely populated regions of the state.

Currently, New Hampshire’s Medicaid covers only treatment of dental trauma, pain and infection, which often results in pulled teeth with no follow-up care. According to the federal government, there are no minimum requirements for adult dental coverage under Medicaid. Most states provide at least emergency services, while fewer than half the states provide comprehensive dental care.

The committee found nearly 16,000 hospital emergency department discharges for nontraumatic dental conditions in 2009, the latest year for which data were available. Most of those incidents were during typical dental practice office hours and involved self-paying patients, indicating that a lack of dental insurance has driven patients into emergency rooms.

The commission said the state should consider expanding coverage to include preventive and restorative services, if funding is available. Based on cost projections from several years ago, the report estimates an expanded benefit plan would cost $11 million to $13 million a year.

Meanwhile, the commission found that there is excess capacity in many dental practices and the ability to serve more patients. It cited multiple factors that contribute to the underutilization of dental care, including financial stress, long work hours, and lack of child care, transportation or oral health knowledge.

The commission recommended that the state increase education efforts to promote the connection between oral health and overhaul health.

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