Originally published in SFGate.

By Victoria Colliver

May 2, 2014

Millions of low-income Californians on Thursday regained many of the dental services they lost five years ago during state budget cuts that virtually eliminated non-emergency dental benefits for adults.

When the state’s fiscal health improved, Gov. Jerry Brown last year agreed to resume funding Medi-Cal dental benefits, known as Denti-Cal.

“We are so thrilled about … the restoration. All of the adults who had Medi-Cal will finally be able to get teeth fixed instead of getting them pulled,” said Elizabeth Landsberg, director of legislative policy for the Western Center on Law and Poverty.

The Legislature stopped short of providing the $130 million needed to fully restore the benefits. Instead, the state will spend $93.9 million over two years for such services as routine cleanings and exams, X-rays, root canals for the front teeth and full dentures. But partial dentures, root canals in the back teeth and some other procedures won’t be covered.

Bay Area dentists who cover Medi-Cal patients consider it a good start. They said the last few years took a huge toll on their patients, who couldn’t get the kind of routine care, fillings and other services that could save their teeth.

“The only option was to extract teeth,” said Dr. Ariane Terlet, chief dental officer of La Clinica de la Raza, which has clinics in Alameda, Contra Costa and Solano counties.

The 2009 decision to cut the dental care program spared pregnant women and those in long-term care. Emergency dental services also remained intact, as well as coverage for children.

Some clinics continued to see Medi-Cal patients even without reimbursement, although an increasing number of visits had to be classified as emergencies due to infections, decaying teeth and other serious mouth problems.

“We got them out of pain. We managed what we could for them,” said Dr. Russ Woodson, quality assurance coordinator at the University of the Pacific’s Arthur A. Dugoni School of Dentistry in San Francisco and regional screening consultant for the Denti-Cal program.

At Alameda Health System’s Highland Hospital in Oakland, the number of emergency-department visits for dental problems rose from 2,425 in 2007 to a peak of 4,710 in 2011.

The hospital has seen a 50 percent increase in oral cancer diagnoses in just the past year, said Dr. Tony Mock, who directs the dental clinic and serves as chief of general dentistry for the county health system.

Mock and other health advocates worry about having enough dentists to take care of both longtime Medi-Cal patients who haven’t had dental services for five years and nearly 2 million patients who became eligible for Medi-Cal this year through the expansion of the federal Affordable Care Act.

The Oakland clinic is adding more staff and starting a new residency program, Mock said, but it still may not be enough.

Medi-Cal patients like Jenine Smith are grateful to have someplace to go for dental care.

“I’m glad they’re restoring them,” Smith said. “There are a lot of us Baby Boomers here, and we need this.”

The 62-year-old Oakland woman’s surgeon referred her to Highland’s dental clinic to make sure she didn’t have any infections or other dental problems that could cause bacteria to enter her bloodstream and complicate a scheduled knee replacement surgery.

Turns out Smith had two abscesses and will need two back teeth removed and a filling replaced before her surgery this month.

Edited on June 15, 2018.