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MassHealth Dental Program Train the Trainer Presentation 2013
Agenda Dental Disease MassHealth Dental Benefits Find a MassHealth Dentist
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State of Oral Health in America
Employees lose more than 164 million hours of work a year due to dental issues. (over 82,000 k years)) 1 work
More than 51 million school hours are lost each year to dental illness. (Over 45,000 school years)
One out of every two people over age 30 suffer from periodontal disease. 2
Tooth decay affects nearly 20% of 2-4 year-olds, more than 50% of 8 year-olds, and more than 75% of 17 year-olds. 3
1.U.S. Dept. of Health and Human Services, Oral Health in America: A Report of the Surgeon General, National Institutes of Health, 2000. 2. Centers for Disease Control and Prevention, Journal of Dental Research, August 2012 3. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Oral Health: Preventing Cavities, Gum Disease and Mouth and Throat Cancer, 2003
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There are Two Major Types of Dental Disease:
1. Caries (Cavities/Decay) 2. Periodontal (Gum) Disease Both Are Caused By Bacteria Both Are Preventable
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HEALTHY TEETH*
PLAQUE ON TEETH
WHITE SPOT LESION AND EARLY TOOTH DECAY*
TEETH WITH DECAY
SEVERE TOOTH DECAY WITH DENTAL ABSCESS*
TEETH WITH RESTORATIONS
* Photo courtesy of Dr. Joanne Douglass BDS, DDS
Plaque + Sugar = Acid
Acid + Tooth = Decay
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How Do We Get This Harmful Bacteria? Children exposed to bacteria l iin lif h early life h have a hi higher incidence of tooth decay. Primary transmission of cavity causing bacteria is from mother to child Transmission includes kissing and tasting the infant’s food before feeding them.
PREGNANT WOMEN
Remember that good dental health is very important to pregnant women and their unborn children. The health of a mother’s gums can affect her unborn baby’s health. Research shows that a pregnant woman with gum disease has a better risk of having a baby too small. Pregnant women should see a dentist at least one time during pregnancy. Necessary treatment can be provided throughout pregnancy.
1Offenbacher, Steven, “Periodontal Infection as a Possible Risk Factor for Preterm Low Birth Weight” Journal of Periodontology 1996 October; 67 (10 Suppl): pp.1103-1113.
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Periodontal “Gum” Disease Gum disease doesn’t hurt,, so you y might g not know yyou have it. If your gums bleed when you brush, you may have gum disease. The best way to ease chances of gum disease is to brush your teeth at least once a day, but twice a day is better. If you think you might have gum disease, see your dentist. Early gum disease is easy to treat.
1Offenbacher, Steven, “Periodontal Infection as a Possible Risk Factor for Preterm Low Birth Weight” Journal of Periodontology 1996 October; 67 (10 Suppl):pp. 1103-1113
Important Messages Children should see their dentists by the age of one. Brush your teeth twice a day for two minutes another Flossing should begin for any teeth that touch one another. Visit the dentist for a checkup every six months. Never allow your children to fall asleep with a bottle of milk, formula, fruit juice, or sweetened drinks in their mouth. Replace toothbrush when bristles appear worn. Change your toothbrush every 3 months Assist children with tooth brushing until age 7 or 8.
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MassHealth Dental Program Goals Improve oral health and wellness for more than 1 million MassHealth p members Improve member access to dental care Streamline program administration Increase provider participation in the MassHealth Dental Program C Create partnership between large eate and sustain s stain a pa tne ship bet een MassHealth and the la ge public health community.
Overview of Dental Benefits Effective July 1, 2010, certain dental services are no longer covered f M H lth Members M b d 21 and d older ld who h are nott for MassHealth aged Department of Developmental Services (DDS) clients. Eligible MassHealth adult members who are not DDS clients can still maintain full coverage for these services under the Heath Safety Net program which is only available through Community Health Centers. For information on the Health Safety Net, go to www.mass.gov/healthsafetynet. www mass gov/healthsafetynet
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Overview of Dental Benefits The following g dental services are covered onlyy for Adults aged g 21 and ld who h qualify l f as Department off Developmental l l Services (DDS) older clients (if medically necessary):
Diagnostic services (exams & x-rays) Preventive services (cleanings) Restorative (fillings) Periodontics (deep scaling) Crowns Extractions (removing teeth) Root canal treatments Dentures Emergency and urgent care
Overview of Dental Benefits The following dental services are covered for Children under age 21 (if medically necessary):
Diagnostic services (exams & x-rays) Preventive services (cleanings, fluoride & some sealants) Crowns Restorative (fillings) Oral Surgery -Extractions (removing teeth) Root canal treatments Orthodontic (if medically necessary) Emergency and urgent care
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Overview of Dental Benefits Th ll i d t l services i d ffor all ll Ad lt aged d 21 and d older ld The ffollowing dental are covered Adults (including DDS clients) when medically necessary: Diagnostic services (exams & x-rays) Preventive services (cleanings) Extractions (removing teeth) Anesthesia Certain oral surgeries such as biopsies and soft tissue surgery Emergency and urgent care House/facility call Behavior management Treatment of complications related to surgery
Member Resources
For more information on the MassHealth Dental Program please visit www.masshealth-dental.net or call Member Services at 1-800-2075019 5019.
If members have concerns about finding a dentist or the quality of care received, or if the member feels he or she has been treated unfairly, please contact DentaQuest at 1-800-207-5019, or send a letter to: DentaQuest MassHealth Dental Program Attn: Complaints and Grievances 12121 North Corporate Parkway Mequon, WI 53092 M q
Members may also contact the State Enrollee Help Line at 1-800-841-2900 with other concerns.
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MassHealth ID Cards Cards can be used immediately by MassHealth members. Members can receive a new card at no cost. To get a replacement ID Card, or to report an address change, members can contact Customer Service: 1-800-841-2900, or email
[email protected] Please remember that a MassHealth card does not guarantee eligibility for services. You must continue to verify eligibility on the date of service.
Fluoride Map
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The Dental Home
How to Find Your Dental Home on the Internet -Go to www.masshealth-dental.net -Click on General Public
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Click -Find Provider
How to Find Your Dental Home on the Internet D ti t closest l t tto th b will ill show h Dentists the member on th the screen.. Members can select a dentist that meets their needs.
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How to Find Dental Information and Educational Materials
-Go to
www.masshealth-dental.net -Click on General Public
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Click -Documents
Dental Information and Educational Materials
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DentaQuest Boston Contact Information Tracy Chase – Executive Director 617-886-1310 Phone: 617 886 1310 Email:
[email protected] Megan Mackin – Outreach Coordinator Phone: 617-886-1728 Email:
[email protected] Arielis De La Rosa –Intervention Specialist Phone: 617-886-1726 Email:
[email protected] Felicia Moses – Intervention Specialist Phone: 617-886-1725 Email:
[email protected]
DentaQuest Provider Relations Contact Information i lA h b l – Provider id Relations l i i ((West)) Daniel Archambault Representative Phone: 617-886-1736 Email:
[email protected] Keishia Lopez – Provider Relations Representative (East) Phone: 617-886-1727 Email:
[email protected]
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Thank you! D l i collaborative ll b ti relationships l ti hi with ith entities titi iin Developing Massachusetts interested in improving oral health is key to the success of the program. We look forward to working with all of you!
Questions? Q ti ?
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