Minnesota doesn’t come in last among all the states very often, but it’s dead last in Medical Assistance payments to dentists.

That’s because Minnesota hasn’t raised its compensation rate to dentists since the early 1980s, and it now amounts to about 31 cents on the dollar, said Jane Neubauer, regional dental services coordinator for Partnership4Health in Otter Tail County. That’s less than a third of what clinics receive from non-MA patients.

That’s also why there is a waiting list 1,342 people long for an appointment at Apple Tree Dental in Hawley. That doesn’t include existing patients -- it’s new people trying to get in to see a dentist. “It’s really a bad situation,” Neubauer said. Those people are hoping for someone to cancel an appointment so they can get in. At the end of each month, they have to sign up for the waiting list all over again, Neubauer said.

There’s a reason that Apple Tree is swamped: Nobody else will take new Medical Assistance patients. “There are no dental clinics in Becker County that are accepting new Medical Assistance patients,” she added. “A few clinics will serve existing MA patients, but not new ones.”

Apple Tree is considered a critical access dental care provider, because more than 25% of its patients are enrolled in Minnesota medical insurance plans. As a critical access provider, Apple Tree receives a higher compensation rate -- about 48 cents on the dollar, Neubauer said.

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Not being able to see a dentist can be a big problem for kids -- they miss out on protective treatments and regular dental care, and an unhealthy mouth has been found to cause health issues throughout the body, said Becker County Commissioner Barry Nelson. “We all know that dental health is the core of your health,” he said at Tuesday’s County Board meeting.

Board Chairman Ben Grimsley reported on the issue to the full board after Neubauer briefed the county human services committee on the problem.

Unfortunately, it’s not just a few kids falling through the dental cracks: In Becker County, two-thirds of the 1,734 kids (age 5 and under) on Medical Assistance last year were not able to see a dentist. Only about 600 of those kids were able to see a dentist, she said.

In Otter Tail County, just 669 kids out of 2,437 were able to get in to a dentist last year, she said.

“Health care for young patients prevents more significant problems down the road,” Neubauer said. “It’s painful for the patients and expensive for the system,” she said, since expensive emergency room care is the only other option for those who can’t get dental help.

And the problem is not going away: There are now 1.5 million Minnesotans on Medical Assistance, up from about 500,000 about 20 years ago, Neubauer said.

Minnesota’s Medical Assistance program is funded through a combination of federal Medicaid and state healthcare dollars, and it would cost Minnesota about $170 million a year to raise its Medical Assistance compensation rate to 85% for dental work, but that would take care of a mouthful of problems, Neubauer said.