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December 8, 2014

Shortchanged in ACA, dentists hope exchanges can boost coverage

The Affordable Care Act impacts health care providers of all types, but dentists were largely disappointed by its shortcomings in expanding dental coverage.

While the ACA deemed dental benefits “essential,” requiring insurers to offer dental plans to children up to age 18, the law did not mandate that those plans be purchased, and insurers don't have to offer the same plans for adults.

Though the ACA is still evolving, Dr. Anthony Giamberardino, president of the Massachusetts Dental Society, headquartered in Southborough, said “the adults are definitely getting the short end of the stick” when it comes to dental coverage. This is despite numerous medical studies that have linked oral health to overall health.

But on the positive side, Giamberdardino believes state and federal health care exchanges, the marketplaces where consumers can shop for health and dental insurance, have made people more aware of available dental plans, which could prompt more people to buy coverage.

However, Giamberardino was dubious about whether the ACA's deeming of dental coverage as necessary for children will go very far in expanding coverage for them. He noted that implementation of the ACA is still a work in progress, so the final impact is unknown.

“If it's going to have an effect, that's where it is going to happen,” Giamberardino said.

Dentists boost outreach

Open enrollment in the federal marketplace — the second open enrollment period since the ACA took effect Jan. 1 — runs from Nov. 15 to Feb. 15, and dental practices are stepping up marketing efforts during this period, even if the ACA has only a nominal impact on coverage.

Vanessa Costa, principal at Advantage Benefits Group Inc., a Worcester-based employee benefits manager, said they're trying to reach employers who may be offering pediatric dental coverage to their employees for the first time. While large companies typically offer full-service health plans that include dental coverage, Costa said she expects that more small businesses will continue to sign up for such plans.

“(Dental practices) are a business, just like any other business, so I think they're trying to seize the opportunity,” Costa said. Giamberardino, of the Massachusetts Dental Society, said that while some consumers can afford to buy dental insurance on their own without having to go through an employer, benefits are capped annually, so there's no coverage after a patient reaches the cap.

“It's almost like a dental gift card,” Giamberardino said.

And since the state and federal governments slashed Medicaid funding for dental benefits for low-income adults in 2012, sharply reducing federal reimbursements to dentists, access to dental care seems largely determined by one's socioeconomic standing.

Not your father’s dentist?

But there's another obstacle to getting people to visit the dentist, according to Dr. Paul Feuerstein, a Billerica dentist who is also technology editor for the industry publication "Dentistry Today." That obstacle is fear.

Through advances in technology, which is still rapidly evolving, Feuerstein said many procedures that were difficult and painful in the past have become much less so. In some cases, laser technology allows dentists to fill cavities without giving patients anesthesia. Also, silver fillings are relics, he said, having been replaced by a plastic material that can fill smaller gaps and is more aesthetically pleasing.

Marketing these changes to adults, who grew up scared of dentists, is important in building clientele, Feuerstein said.

“The challenge has been to reeducate the new grownups … to come to the dentist,” Feuerstein said.

But it's not just about making the experience more pleasant for patients. New technology has also increased efficiency for dentists, said Michael Cataldo, CEO of Convergent Dental.

The Natick-based dental technology company this year launched its first product, Solea, an FDA-approved laser system that's used in both hard- and soft-tissue procedures. According to Cataldo, the system eliminates the need for anesthesia in 98 percent of procedures, and causes no bleeding, offering patients faster recovery time.

With 100 units now in use in the U.S., Cataldo expects that number to double in 2015, and continue to climb as more dentists look to adopt minimally invasive technology.

“It's much more efficient for the dentist, and the patient, who's not sitting in their chair, twiddling their thumbs,” Cataldo said.

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