Oral Health Resources

dad and son brushing teeth and looking in the mirror

Good oral health has a positive impact on overall health, which is why dental health visits are included in our Quality Care Plus program. We encourage participating PCPs to discuss the importance of oral health and regular dental visits with their patients. Learn more below about important oral health resources for providers.

How PCPs Can Help

To maintain and achieve good oral health, people of all ages should have a dental exam at least once a year, as they allow the oral health care team to provide necessary preventive services, monitor oral growth or development, provide guidance to caregivers and parents and diagnose and treat for decay disease.

As dental needs change throughout different stages of life, medical providers must stay informed about oral health challenges at each stage. This knowledge empowers them to tailor their conversations with patients for optimal care.

Primary care providers are encouraged to refer their patients to the dentist if they have not seen the dentist in over a year or if they do not have a dental home.

See below for additional provider resources to learn more about oral health:

Dental Services and Prevention

Preventive dental services include regular oral exams, cleanings, and x-rays for people of all ages. For children, these services include fluoride application and dental sealants. Whether performed at the primary care office or at the dentist office, topical fluoride varnish can strengthen enamel and prevent early childhood caries. In addition to fluoride varnish, dental sealants can be placed on permanent molars and premolars to prevent pit and fissure caries.

Adult and pediatric dental benefits for our members cover exams, radiographs, cleanings, basic restorative and oral surgery services. Other services may require prior authorization.

Oral Manifestations of Medical Conditions

Consideration of oral manifestations of medical conditions is important when treating the whole person. Examining the oral cavity can be a source for early detection of other medical concerns, as many systemic conditions impact oral health and present through varying oral symptoms.

Oral bacteria has been linked to endocarditis, cardiovascular disease, pregnancy and birth complications. For additional information, read more about oral-systemic health from the American Dental Association.

Dental Benefits for Members

Avesis is our dental benefits manager for all lines of business. All claims, prior authorizations, contracting and credentialing are completed through Avesis.

Have questions regarding dental benefits for your patients? Call the Avesis provider relations team at 855-536-7764 or log in to the Avesis portal.

If members are looking for a dentist, they can visit the provider directory or call the Member Relations number on the back of their ID card for assistance.