Uncategorized – Arkansas State Dental Association

Open Letter to Legislators Re: Medicaid

Billy Tarpley on December 16, 2024

The dentists of Arkansas and the Arkansas State Dental Association (ASDA) proudly support the Arkansas Medicaid dental program. With one of the highest participation rates in the nation, more than 700 Medicaid-enrolled dentists currently treat those patients most in need of dental care across our state. However, the decision to enroll and re-enroll as Medicaid providers grows increasingly difficult for Arkansas dentists. The rising costs of materials, lab fees, and staff time associated with dental Medicaid coverage are but a few of the issues our dentists face. Moreover, the reimbursement rate for Medicaid-covered services last set back in 2007 inadequately addresses these expenses.

As you may know, the Arkansas Department of Human Services (DHS) recently opted not to continue with the dental managed care organization (MCO) system which facilitated the dental Medicaid system for the last several years. Instead, DHS decided to transition Arkansas dental Medicaid back to a fee for service (FFS) system. This means that Medicaid-enrolled dental practices will now be directly responsible for keeping track of and filing claims for Medicaid-covered services and seek to be reimbursed directly for those services. While cutting out the middleman serves to cut costs for DHS, this change incurs additional staff time and costs on enrolled dental practices. As a result, many dentists face the difficult choice of whether to continue as a Medicaid provider.

A 2022 survey of Arkansas dentists (n=212) currently providing services to Arkansas Medicaid beneficiaries indicated some serious concerns:

90.4% of responding dentists indicated that Arkansas Medicaid does not adequately reimburse them for services provided.
73.6% indicated that if Medicaid rates remain at the current level they may have to stop treating Medicaid beneficiaries in the future.
Only 7.6% of dentists indicated that they will still be Medicaid providers within 3 years of 2022 if rates do not increase.

The Medicaid dental providers of Arkansas raised these concerns over two years ago, and they only grow larger and more dire today. As 2025 fast approaches, so too approaches an access-to-care crisis for one of Arkansas’ most vulnerable patient demographics. Nothing short of prompt and decisive support by DHS will avert this looming cessation in dental Medicaid coverage.

RATIONALE and REQUEST:

On behalf of all current Medicaid-enrolled Arkansas dentists, the ASDA requests an increase in the current dental Medicaid reimbursement rate, last established in 2007 to be increased for all covered treatments and services at a rate necessary to maintain the current level of providers.By way of this proposal, ASDA demonstrates its long-held objective of advocating for the oral health of our public by advocating for the success and support of our dentists and dental workforce. The issues facing our dental Medicaid system are many and complex, but we are committed to working together with our fellow stakeholders to find creative and lasting solutions.

Options for Training to Meet DEA MATE Act Requirements

Billy Tarpley on August 14, 2023

The courses linked below are designed to meet the requirements of the Drug Enforcement Agency (DEA) Medication Access and Training Expansion (MATE) Act, which is mandated for all prescribers of certain schedule drugs prior to their next renewal. Be aware that some but not all require a registration fee.

This is made available primarily to dentists who must renew their DEA license prior to March 1-2, 2024, when the ASDA plans to present Dr. Tom Viola’s courses which will satisfy the necessary training.

From the American Dental Association: T
The following one-hour webinars are hosted by the ADA and include CE credit. Many the courses are free for ADA members, and some are free for non-members. The ADA is a designated training provider.

https://www.ada.org/resources/practice/wellness/opioid-education-for-dentists

From the University of Minnesota Dental School:

https://dentistry.umn.edu/continuing-dental-education/courses/dea-required-8-hour-training-opioid-prescribing-and-pain-management-dental-professionals-zoom-webinar

The top 3 challenges facing dentists in 2023

Billy Tarpley on February 1, 2023

What’s in Store for the Dental Sector in 2023?

American Dental Association, February 1, 2023 –

2023 marks the third year of the ADA Health Policy Institute’s monthly polling around the perspectives of practicing dentists on the dental economy and other current events impacting the industry. Whether you’ve been with us from the start or joined somewhere along the way, we thank you for your continued interest and insights as we begin another year together. Now that the books have closed on 2022, we’re surveying the dental landscape of 2023. The December and January waves of HPI’s Economic Outlook and Emerging Issues in Dentistry poll find that dentists are actively anticipating and taking action for the year ahead:

Top 3 Challenges: The top concerns dental practices are dealing with are staffing, rising operating costs, and stagnant insurance reimbursement levels. There will continue to be margin compression.
Top 3 Practice Preparations: The top actions dentists plan in 2023 are raising fees, hiring more staff and dropping out of some insurance networks. Nearly three out of four dentists plan to raise their fees, 2 out of 5 dentists want to hire more staff, and more than a third intend to drop out of some insurance networks.

Other key takeaways include:

Recruitment Needs: Recruitment needs for dental hygienists and assistants slightly declined again in January. But by no means is the shortage over. Dentists continue to say recruitment is extremely challenging.
Practice Schedules: Dental practice schedules remain steady at the start of 2023, with schedules 85% full on average in January. For several months, we have been in a ‘holding pattern’. Increasingly, dental practices are saying ‘not enough patients’ is the key reason they are not busier, compared to ‘staffing shortages’ which was a much bigger reason a year ago.
Dental Spending: The December data show no big developments in terms of dental spending trends. Here too, we appear to be in a ‘holding pattern’. It is unlikely there is any more pent-up demand to work through, and we may be hitting a new “steady state.”

CLICK HERE FOR THE FULL RESULTS

ADA: Half of Dentists Say Patients Are High at Dental Appointments

Billy Tarpley on November 3, 2022

Medical Marijuana Use May Affect Oral Health and Treatment

CHICAGO, November 3, 2022 – As personal and medical marijuana use increases nationwide, the American Dental Association (ADA) suggests patients refrain from using marijuana before dental visits after a new survey finds more than half of dentists (52%) reported patients arriving for appointments high on marijuana or another drug.

Currently, recreational marijuana use is legal in 19 states and the District of Columbia, with five more states voting on ballot measures Nov. 8. Medicinal use is legal in 37 states and the District of Columbia.

“When talking through health histories, more patients tell me they use marijuana regularly because it is now legal,” says ADA spokesperson Dr. Tricia Quartey, a dentist in New York. “Unfortunately, sometimes having marijuana in your system results in needing an additional visit.”

That’s because being high at the dentist can limit the care that can be delivered. The survey of dentists found 56% reported limiting treatment to patients who were high. Because of how marijuana and anesthesia impact the central nervous system, 46% of surveyed dentists reported sometimes needing to increase anesthesia to treat patients who needed care.

Findings were uncovered in two online surveys earlier this year – one of 557 dentists and a second nationally representative survey of 1,006 consumers – conducted as part of trend research by the ADA.

“Marijuana can lead to increased anxiety, paranoia and hyperactivity, which could make the visit more stressful. It can also increase heart rate and has unwanted respiratory side effects, which increases the risk of using local anesthetics for pain control,” Dr. Quartey said. “Plus, the best treatment options are always ones a dentist and patient decide on together. A clear head is essential for that.”

Studies have also shown regular marijuana users are more likely to have significantly more cavities than non-users.

“The active ingredient in marijuana, THC, makes you hungry, and people don’t always make healthy food choices under its influence,” Dr. Quartey said. “Medically speaking, munchies are real.”

The science behind oral health and marijuana is beginning to emerge, particularly when it comes to edible or topical forms. Still, there are strong indications that smoking marijuana is harmful to oral and overall health. The ADA surveyed 1,006 consumers in a second poll around marijuana and vaping use. The results of the representative sample found nearly 4 in 10 (39%) patients reported using marijuana, with smoking the most common form of use. Separately, 25% of respondents said they vaped, and of those respondents, 51% vaped marijuana.

“Smoking marijuana is associated with gum disease and dry mouth, which can lead to many oral health issues,” Dr. Quartey said. “It also puts smokers at an increased risk of mouth and neck cancers.”

The ADA has called for additional research around marijuana and oral health and will continue to monitor the science to provide clinical recommendations for dentists and patients.

In the meantime, survey results show 67% of patients say they are comfortable talking to their dentist about marijuana. The ADA recommends dentists discuss marijuana use while reviewing health history during dental visits.

“If we ask, it’s because we’re here to keep you in the best health we can,” Dr. Quartey says. “If you use it medicinally, we can work with your prescribing physician as part of your personal healthcare team.”

In the meantime, patients who use marijuana can stay on top of their oral health with a strong daily hygiene routine of brushing twice a day with fluoride toothpaste, cleaning between teeth daily and visiting the dentist regularly and making healthy snack choices.

For more information on the oral health effects of marijuana, visit ADA.org.