In Hawaii, approximately 50 percent of our 365,000 Medicaid beneficiaries essentially have only one option for insured dental services — the emergency room.

While nearly all states and Washington D.C. cover some dental services for their adult Medicaid populations, Hawaii covers only emergency tooth extractions. It’s been a decade since adults covered by Hawaii Medicaid have had dental coverage, and we think it’s time to make a change.

Beginning January 2019, AlohaCare and ‘Ohana Health Plan are voluntarily offering adults eligible for Medicaid basic dental care benefits such as biannual teeth cleanings, an annual exam, fluoride treatment, bitewing x-rays and one filling or non-emergency extraction.

The keiki and seniors who make up the other half of Hawaii’s Medicaid population already receive Medicaid and Medicare Advantage dental coverage. Without some dental coverage, adults often forego care choosing to meet family needs, like food on the table, over a dentist appointment for a toothache.

Sheila Beckham, CEO of Waikiki Health, says their community health center sees about 100 to 150 patients every week. Many of them are Medicaid beneficiaries who have neglected their oral health for years because they haven’t been able to afford dental insurance or pay out of pocket for dental care. The staggering results are severe tooth decay and periodontal or gum disease. Without regular x-rays or yearly exams, a small cavity can lead to broken teeth, dental infections, and possibly root canals or extractions.

Like all health care, preventive dental care is the best type of care. Early intervention stops the onset of disease and focuses on whole-person wellness. Studies have proven there are links between gum disease and higher risks of heart attack, stroke, diabetes and rheumatoid arthritis. Pregnant women also need good oral health care because oral health diseases has been shown to cause low-birth rates and pre-term births.

This approach aligns well with the priorities of the Hawaii Medicaid program, which seeks to address physical, behavioral and social determinants of health to create healthy communities. As Hawaii Medicaid partner organizations, it is important to us that we to support this critical initiative.

Financially, the stakes are high, and we believe proactive care is the wisest choice because it reduces long-term costs. According to the Hawaii Department of Health’s key health findings report, in 2012, there were more than 3,000 emergency room visits in Hawaii for preventable dental problems that represented more than $8.5 million in hospital charges. We believe making a basic dental benefit available could help to reduce those costs.

Positive change has to start somewhere. AlohaCare and ‘Ohana Health Plan believe absorbing the cost of providing these benefits is a small but important step in the right direction to provide quality health care to Hawaii’s most vulnerable populations. Investing in oral health makes good financial sense and that should give all of us a reason to smile.

Laura Esslinger is chief executive officer of AlohaCare, and Scott Sivik is state president of ‘Ohana Health Plan.