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Does Medicaid For Pregnancy Cover Dental?

Written by: Jody Adams
Last updated: January 31, 2024

Dental care is expensive, so most people look for dental clinics that accept Medicaid to provide free or low-cost coverage. Dental care is crucial for pregnant women, as untreated dental problems can lead to complications like preterm delivery and low birth weight. 

According to the CDC, access to oral healthcare continues to be a problem in the US, as 1 in 4 women of childbearing age has untreated cavities. Fortunately, all states provide pregnancy-related Medicaid coverage. 

Read on to further understand how Medicaid for pregnancy covers dental care and how it can make the most out of your dental care plan.

What To Know About Maternal Dental Care

What To Know About Maternal Dental Care

Pregnancy can cause tooth decay, gum disease, cavities, tooth erosion, and periodontal disease in some women because of fluctuating hormone levels. Without preventive care, such oral infections can result in preterm birth. 

The disparity in oral health care continues to be driven by the lack of access to comprehensive oral health care, especially for low-income individuals. 35% of women in the US have not gone to see a dentist last year, and more than half of all women have not seen a dentist while pregnant.

Medicaid and CHIP provide coverage for pregnant women residing legally in the US. However, while preventive and emergency dental services are covered, there is substantial variation among states in their dental coverage.

  • Medicaid coverage for women below 21 years: provides coverage for comprehensive dental care, which includes relieving pain and infections, restoring teeth, and maintaining dental health.
  • Medicaid coverage for women above 21 years: may provide coverage for some procedures based on their state's rules regarding emergency, therapeutic, preventive, oral surgery, periodontal, and orthodontic treatment.

Types Of Dental Care Pregnant Women Can Get

You can still have most dental procedures performed while pregnant if you treat your dentist as part of your healthcare team. Whenever you schedule an appointment with your dentist, let him or her know that you are pregnant. 

They will carefully consider which treatments are appropriate and whether additional precautions are necessary. However, most basic dental care types can be done safely during pregnancy during the second and third trimesters.

  • Dental x-rays: they are safe during pregnancy. You should inform your dentist in advance so they can properly protect you and your baby.
  • Tooth extractions: they are safe for pregnant women. The second trimester is best because you don't want to lie on your back for too long in the third trimester due to your baby's developing organs.
  • Dental fillings: It is possible to treat cavities safely. Wait until after the first trimester is over to avoid nausea. Certain fillings can contain potentially toxic materials for the baby, so it's important to discuss different amalgams with the doctor beforehand.
  • Dental cleanings: they are both safe and recommended. Proper dental cleaning can prevent cavities and oral infections.

Oral Healthcare And Maintaining A Healthy Pregnancy 

Oral Healthcare And Maintaining A Healthy Pregnancy 

Approximately 60 to 75% of pregnant women suffer from gingivitis or periodontal disease. Prenatal care should include oral health since poor oral health during pregnancy may negatively affect the health of both mother and child. The likelihood of having cavities as a child is more than three times higher for children of mothers who have tooth loss or untreated cavities.

Most mothers are hesitant to undergo any dental treatment during pregnancy. It is not possible to postpone necessary dental treatments until after birth due to possible risks to the baby.

If you have problems in your mouth but cannot afford to undergo dental procedures, Medicaid may be able to help.

Medicaid And Pregnancy Related Services

In most states, Medicaid covers dental care for children under 21 years of age; however, dental services for adults over 21, including pregnant women, are optional. Programs like Medicaid are vital for low-income pregnant women to help them afford their dental care. 

Many factors determine what state policies cover when it comes to pregnancy-related services, but federal law sets the following baseline requirements:

  • Income eligibility: Medicaid coverage is required in all states for pregnant women earning up to 138% of the federal poverty level, but many states require higher eligibility thresholds.
  • Cost-sharing: A state cannot impose cost-sharing requirements on pregnant beneficiaries.
  • Benefits: Federal laws give states discretion about what services to cover for pregnant beneficiaries beyond hospital and outpatient care. 

Demonstration Projects For Reducing Health Disparities

It is possible to reduce health disparities through these projects, which raise public awareness, strengthen families, and improve economic outcomes and educational opportunities. Additionally, they can identify policies and effective approaches to improving healthcare. The CDC administers the REACH initiative to reduce health disparities. 

Frequently Asked Questions

Pregnant women often wonder whether dental care is safe during pregnancy. We have addressed some of the most common questions about dental care during pregnancy. 

What kind of dental work can a pregnant woman get?

Dental x-rays, fillings, cleanings, and tooth extractions can be done safely. However, it is safer to undergo these procedures in the second trimester. It is important to discuss fillings with your dentist.

Can I still get dental work done while pregnant?

Studies have shown that pregnant women can safely undergo most dental procedures. However, it is recommended to have it done in the second trimester rather than the first or third and avoid complicated or unnecessary procedures. Before having any dental work done, you should inform your doctor that you're pregnant.

What happens if you have a cavity while pregnant?

Cavity-causing bacteria could be transmitted from the mouth of the mother to her baby during pregnancy and after delivery. It's important to visit the dentist regularly to prevent and treat dental problems like cavities.

Why do so few dentists accept Medicaid?

Due to Medicaid's low reimbursement rates, most dentists are reluctant to accept Medicaid patients. The dentists also argue that Medicaid doesn't cover enough dental services.

Do I need to tell my dentist I am pregnant?

When you're pregnant, tell your dentist at your appointment. Your dentist will tell you which dental procedures you should have done and what elective procedures can wait. You may also receive special instructions or precautions from them.

Dental Coverage During Pregnancy

The high costs of dental care and the lack of insurance are the top cited reasons for not seeking dental care. This is why most people wonder, "does Medicaid for pregnancy cover dental care?

Medicaid covers essential dental services during pregnancy; nevertheless, access to dental care and insurance eligibility remains a major hurdle for low-income mothers.

Need help in finding dental offices that accept Medicaid? Check out our comprehensive guide about dental offices that accept Medicaid.

Mothers can face numerous financial challenges. If you are having financial difficulties, you may find resources for government financial assistance useful.

Jody Adams
Jody Adams is an accomplished editor-in-chief with a deep understanding of social care and government benefits issues. With a background in journalism and a master's degree in Public Policy, Jody has spent her career shaping the narrative around social policies and their impact on society. She has worked with renowned publications, effectively bridging the gap between complex policy analysis and public understanding. Jody's editorial expertise ensures that vital information on social care and government benefits reaches a broad audience, empowering individuals to make informed decisions.
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