Low-income Minnesota families struggle to get dental care

Dr. Megha Agrawal examines the teeth of 9-year-old Lanajah Chase, who visited the dentist for the first time. She was treated at the Children's Dental Services clinic, which specializes in care for children on the Medical Assistance public health program. 

Partly nervous and partly excited, Lanajah Chase slid into a dentist's chair for the first time this week.

As her mother and two siblings watched, the 9-year-old donned an apron before a technician at Children's Dental Services in northeast Minneapolis took some X-rays. 

"This thing is heavy," Lanajah said. 

She was instructed her to "open up super big, like an alligator." The girl did as she was told, and within 10 minutes her appointment was done.

She was all smiles after the dentist told her she didn't have any cavities and could come back another time for a full cleaning. Getting through that first appointment was easy. Getting it in the first place wasn't.

Like for many families on Medical Assistance — the state's version of Medicaid — finding dental care is tough. Lanajah's mother, Denise Stone, wanted to get her children into a clinic closer to their New Hope home. But some dentists weren't accepting patients on Medical Assistance or had untenable waits. 

"All of the other ones were out booked far, like February of next year," Stone said. 

About 655,000 Minnesota children were enrolled in Medicaid, but only 36 percent of them received dental services included in their coverage, according to 2017 statistics. That puts Minnesota noticeably below the national average.

The number of dentists who see children in public programs declined from 2,906 in 2015 to about 2,253 last year, according to the Department of Human Services. 

There are several causes, but relatively low reimbursement rates are a key reason.

"For whatever reason, it's been very difficult to get momentum in Minnesota to address our incredibly poor Medical Assistance reimbursement rates," said Sarah Wovcha, executive director for Children's Dental Services.

Advocates for the nonprofit providers are already gearing up to make another case to state lawmakers and Gov.-elect Tim Walz to divert tens of millions more dollars toward childhood dental needs. They know they'll face stiff competition when the Legislature returns to craft a new budget in January, although there's a strong likelihood Minnesota will have a robust surplus.

Meetings with key lawmakers have already begun.