Dental Care

Handbook Content

Terms and Meanings

Some terms that we use in this chapter may not be familiar. These terms and their meanings are listed below.

  • Prior Authorization: A process of approving services, medications, or supplies to be covered.
  • Requirements: Details that are needed to approve a service or program.
  • Referral: A written order from your primary care doctor for you to see a specialist or get certain medical services
  • Provider: A doctor, nurse, therapist, or another qualified health care professional.
  • Screening: To look for serious health concerns.
  • Services: Care, treatments, testing, checkups, equipment, supplies, and other ways your health care providers help you stay healthy.
  • TTY: The number you can call to connect with someone when you have a hearing impairment.

Medicaid helps cover dental care for children and adults. Healthy teeth and gums have a big impact on your health. Some medical conditions and medications can put you at risk for oral health problems like gum disease.

You can take care of your oral health by seeing your dentist for regular cleanings and exams. Coverage starts over for each person every January 1st. 

Dental coverage includes the following services. These services may have limits or requirements based on your age and/or dental situation:

  • 2 exams and cleanings per year
  • Crowns (with prior authorization)
  • Dentures or Partial Dentures (with prior authorization)
  • Fillings and tooth removals
  • Fluoride varnish (kids only)
  • Night guards/TMJ splints Oral Surgery, anesthesia, and follow-up visit
  • Root canal treatment (front teeth only for adults)
  • X-rays

Adults should see their dentist for a routine annual exam, two yearly cleanings, and application of fluoride. 

Members who have mental, physical and/or behavioral health care needs may have dental case management services. These services are designed for members who cannot schedule or coordinate complex treatment plans on their own.

Children, ages 0-20, are still growing and need more dental services. Children should see their dentist twice per year for a routine exam, cleaning, and fluoride varnish. Children should also have sealants applied to their adult molars. Sealants help protect your child’s adult teeth as they start to come in.  Your child can get these treatments at their dentist.

Fluoride varnish can help protect your child’s teeth from cavities. Your child can get a fluoride varnish at participating local public health units and participating providers during their ND Medicaid Health Tracks well-child check. 

As your child’s adult teeth come in, their dentist may perform an orthodontic screening for braces. If your child meets the requirements, they could receive orthodontia services such as braces! Your child can get orthodontia care with a referral from their dentist. They will need two orthodontia screenings, one from their dentist or public health unit, and one from an orthodontist. You can learn more about Health Tracks in the Understanding Your Routine Health Care section of this handbook.

Your dental provider can help you understand the dental services that are covered, if they have limits, or need a prior authorization or referral. 

WHERE YOU CAN GET DENTAL CARE

Dentist Office

You can visit a dentist’s office to get basic oral care. You may be referred to an orthodontist or oral surgeon for other services beyond basic oral care. To make a dental appointment, call the dentist’s office, ask if they accept Medicaid, and if they are taking new Medicaid patients. 

Federally Qualified Health Centers (FQHC) and Rural Health Clinics

Your local FQHC or rural health clinic may offer some dental services in-office or by tele-dentistry. You can contact your local center or clinic to learn more. 

School Setting

Children may be able to get sealants and fluoride varnish application at their school! Find out if your child’s school participates in the SEAL!ND program:

  • Ask your child’s school
  • Contact HHS Oral Health Prevention Coordinator

You can learn more about the School-Based Fluoride Varnish & Sealant Program on the SEAL!ND webpage.

Tele-Dentistry

Tele-dentistry helps you connect, virtually, with your dentist at a distance. Your dentist may meet with you over a video. They may review your imaging, photographs, or impressions through electronic communication. You can learn more about different telehealth options in our Telehealth section of this handbook.

Find a Dentist

To find a dentist in your area:

Contact Information Mentioned in this Chapter

  • Customer Support Center
    • Toll-Free: 1-866-614-6005
    • Local: 1-701-328-1000
    • TTY: 711
    • Free translation available upon request
    • Email: applyforhelp@nd.gov
    • Mail: Customer Support Center
    • PO Box 5562
    • Bismarck, ND 58506
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