Bridgeport Dental Services

Smile Central - Your Healthy Smile Resources


	About Us/Home

	Your Dental Home

	Find a Dentist

	Your Rights and Responsibilities

	Oral Health Information

	Fun for Kids

	Bridgeport Home

	Your Benefits

	Privacy Statement

	Contact Us

Missouri’s MO HealthNet (Formerly Medicaid MC+ Program) Program Dental Benefits

Members who are under 21 years old

Diagnostic Dental Services, including procedures necessary to assist the dentist in evaluating existing conditions and the dental care required. These shall include, but not necessarily be limited to:

a)	Oral examinations twice per plan year not to exceed one every six (6) months.

b)	Diagnostic x-rays, (i) bitewings twice per plan year not to exceed once every six (6) months for Members twenty (20) years old and under

c)	Full mouth x-rays once every three (3) years.

Preventive Dental Services, including but not necessarily limited to:

a)	Prophylaxis/cleaning twice per plan year not to exceed once every six (6) months.

b)	Topical fluoride treatments for Members twenty (20) years of age and under not to exceed once every six (6) months.

c)	Space maintainers, generally found to be dentally efficacious for Members under the age of twelve (12) years for the purpose of premature loss of primary molars.

d)	Sealants for children under the age of seventeen (17) years once every three (3) years for permanent molars with no decay or restorations.

Oral Surgery for the purpose of tooth extractions or in preparation of the mouth for dentures. Restorative Dentistry, such as amalgam restorations, stainless steel crowns, synthetic porcelain and composite white resin restorations. Endodontic Services including pulpotomies when indicated for infected teeth. Prosthodontic Services including full and partial dentures or bridges, which meet Bridgeport’s prior authorization criteria. Orthodontic Services when the State of Missouri’s criteria regarding the patient’s oral hygiene and the HLD Index, or other applicable criteria set or tool has been met.

Members who are 21 years old and over

Adult dental benefits are only for services related to trauma to mouth, jaw, teeth or other contiguous sites as a result of injury. Pregnant women have dental benefits under Missouri’s Medicaid Managed Care Program which are limited to dentures. Extractions and other necessary dental benefits are covered under Missouri’s Medicaid fee for service program.