September 3, 2021
The Honorable Nannette Barragán
U.S. House
2246 Rayburn House Office Building
Washington, D.C. 20515
Dear Rep. Barragán:

On behalf of the American Association of Oral and Maxillofacial Surgeons (AAOMS), which
represents more than 9,000 oral and maxillofacial surgeons (OMSs) in the United States, I wish
to thank you for your leadership on oral health issues in Congress, particularly given yourintroduction of the Medicaid Dental Benefit Act (H.R. 4439). This important legislation would
provide comprehensive and consistent adult dental Medicaid benefits across the country for
those who cannot otherwise afford oral healthcare.
OMSs understand the important role oral health can have on a patient’s overall health. OMSs
are surgically and medically trained dental specialists who treat conditions, defects, injuries,and esthetic aspects of the mouth, teeth, jaws, neck and face. The OMS scope of practicestraddles the line between medicine and dentistry, treating conditions that could be dental ormedical in nature. In fact, AAOMS maintains a list 1 of oral and maxillofacial surgery services it
considers to be “medically necessary” or “essential” because they are integral to a patient’soverall health.

It is well-documented that those who suffer from oral disease, especially periodontic ailments,
are more likely to have chronic health diseases, including diabetes, heart disease and stroke. 2
Access to regular dental care can prevent oral disease. Oral cancer screening and treatment is
one such example involving OMSs. These tumors – especially when they are only very small
lesions – are usually first identified by a patient’s general dentist. The patient is then typicallyreferred to an OMS for further assessment and removal of the cancer lesion. If the cancer iscaught early enough, the patient can avoid subsequent and more extensive treatment.
1 Essentials of Oral and Maxillofacial Surgery Services. American Association of Oral and Maxillofacial Surgeons WhitePaper. January 2021. AAOMS.org/docs/govt_affairs/advocacy_white_papers/essentials_oms.pdf.

2 2020 Leading Health Indicators: Oral Health; Office of Disease Prevention and Health Promotion. Department of Healthand Human Services. HealthyPeople.gov/2020/leading-health-indicators/2020-lhi-topics/Oral-Health. Accessed Aug. 26,2021.

Unfortunately, access to regular oral healthcare is unaffordable to most Medicaid recipients.
While nearly all states provide some level of dental Medicaid benefits for adults, only 21 states
plus the District of Columbia provide “extensive benefits,” defined as “including at least 100
diagnostic, preventive, and restorative procedures, and a per-enrollee annual maximum
expenditure of at least $1,000.” 3 We appreciate your efforts to correct this vast disparity of careamong states through your legislation.
AAOMS is pleased that the Medicaid Dental Benefit Act would also allocate additional financial
resources from the federal government to assist states with providing enhanced dentalbenefits. The federal investment will help ensure these expanded benefits are consistently
offered, and not subject to intermittent cuts during state fiscal downturns, as they are now.

Finally, AAOMS believes the Medicaid Dental Benefit Act also would be a significant tool in its
efforts to provide dental care for the nation’s seniors who can least afford it. We recognize that
other solutions are being discussed in Congress, such as an expanded dental benefit under theMedicare Part B program. AAOMS disagrees, however, that a Part B expansion is the best
approach to providing affordable dental care to seniors. Medicaid already has a robust provider
network that could be further utilized to provide care to low-income seniors, while questions
remain about whether CMS can effectively implement a Part B program and whether it would
attract sufficient providers. We welcome the opportunity to discuss with your office theseconcerns and potential alternatives to a Part B benefit.
Again, thank you for your leadership on oral health issues, particularly through theintroduction of the Medicaid Dental Benefit Act. AAOMS would be pleased to work with you
and your colleagues to advance this important legislation and discuss how to best expand
access to affordable oral healthcare. Please contact Jeanne Tuerk, AAOMS Director ofGovernment Affairs, at 800-822-6637, ext. 4321, or jtuerk@aaoms.org.

Sincerely,B.D. Tiner, DDS, MD, FACSAAOMS President

3 Vujicic M, Fosse C, Reusch C, Burroughs M. Making the Case for Dental Coverage for Adults in All State Medicaid

Programs. ADA Health Policy Institute, Families USA and Community Catalyst Research Brief. July 2021.
ADA.org/~/media/ADA/Science%20and%20Research/HPI/Files/WhitePaper_0721.pdf.