This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.
Oral health care is sadly inaccessible for many Michiganders. According to the Michigan Oral Health Coalition’s (MOHC)
2024 Oral Health Public Policies report, nearly a third of adult Michiganders lack access to oral health care. However, MOHC brings together a multitude of Michigan oral and general health partners to collaborate on improving oral health for all Michiganders, especially those who have barriers to access.
Policy advocacy has been one strong point for the coalition. Kimberly Singh, MOHC board member and chief community and governmental affairs officer for
My Community Dental Centers, notes that the coalition formed in 2003 in response to the elimination of Michigan's adult dental Medicaid program.
"This really caused great concern among dental providers, community partners, and stakeholders that fostered a sense of urgency and cohesion in ramping up the Michigan Oral Health Coalition," she says.
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Kimberly Singh.
Three MOHC wins include the Michigan legislature's approval of
an increase in Medicaid reimbursement rates for dental care,
making oral health care available to adults ages 18 through 64 with Medicaid or Healthy Michigan insurance coverage, and
continuing and expanding oral health care for Michigan’s kindergarteners. Currently, kindergarteners in about half of Michigan's counties are being screened and referred to treatment, if needed.
"The coalition definitely wants to ensure that everyone can attain the highest level of oral health, meaning oral health equity," Singh says. "One big piece is recognizing that [insurance] coverage does not equal access to care. We’re looking to ensure that access for specialty populations and seniors is addressed."
Among these, more Black adults had no dental care within the past year (37.2%) than white (28.7%). Michiganders with the least access are those with the greatest level of disease and decay. In addition, 50.7% of uninsured adults and 41.6% of adults with disabilities hadn’t seen a dentist within the past year.
Michiganders with intellectual and developmental disabilities average two years between dental visits. As a result, they experience health issues which result in over-utilization of emergency room services.
Half of Michigan’s children have untreated tooth decay because they lack proper oral health care and preventative dental care. 33% of these live in low-income households. The most common chronic childhood disease, tooth decay, adversely impacts children’s ability to learn, play, and eat healthy foods when left untreated. When pregnant people do not have access to dental care, their infants are more likely to be born preterm and have low birth weights.
"We were at the table and instrumental in advocating for
Medicaid expansion, and what's referred to as our
Healthy Michigan Plan, where those uninsured adults received medical and dental coverage, a very significant milestone relative to access to care," Singh says. "It’s rewarding to know that, as we're celebrating our 20th anniversary, we've established ourselves as a statewide leader and convener that raises the bar, creating conversations and advocacy around oral health. We do have a pretty lengthy track record of success."
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Kimberly Singh.
State Oral Health Plan addresses workforce, equity, and access
The MOHC also collaborated on the 2025 Michigan
State Oral Health Plan (SOHP) with the
Michigan Department of Health and Human Services (MDHHS) and other partners. The SOHP seeks to raise awareness about oral health, improve oral and overall health for all Michiganders, strengthen oral health infrastructure, and reduce health disparities.
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Chris Farrell.
"I think people don't realize just how much oral health impacts your overall health – not just your physical health, but your mental health. It impacts how you eat, how you speak, the types of jobs you get, your education. Oral health, mental health, and physical health, they're all intertwined," says Chris Farrell, director of the MDHHS Oral Health Program. "When the plan was developed, we had three main goals — that Michiganders understand the value of daily oral health care and preventive dental care, have the tools to care for their mouths every day, and have access to preventive and restorative oral health care."
MDHHS already has many oral health programs in place. The Michigan Dental Program serves people who are HIV positive. Varnish! Michigan provides free fluoride varnish to medical providers. And SEAL! MICHIGAN supports school-based dental sealant programs. Its Oral Health Program also provides up-to-date information on community water fluoridation and medical conditions impacted by poor oral health.
"We are working to embed dental hygienists into medical practices," Farrell says. "Pre-pandemic and during the pandemic, we embedded a hygienist in certain [
Federally Qualified Health Centers] in their OB/GYN clinics to help pregnant women learn about the value of dental care. We also have a pediatric office in an Upper Peninsula medical practice. We are hoping that we will be able to expand and embed a hygienist or a community health worker into three more medical practices to help the patients get dental care."
Another challenge the plan addresses is the workforce shortage among dentists and hygienists. MDHHS is working with
Ferris State University to develop a new dental therapy program. Dental therapists could work in underserved areas to provide fillings and simple extractions. A proposed program offering tele-dentistry could provide education, nutritional counseling, tobacco counseling, and oral cancer education while helping connect patients with needed care. And yes, the tele-dentist will have patients open their mouths for the camera.
"That Medicaid adult dental reform has really changed the face of dental benefits," Farrell says. "Now, besides fillings, they can get root canals, some limited crowns, and a lot more services to preserve their teeth."
Filling gaps at the local level
Jim Milanowski, president and CEO of the
Genesee Health Plan (GHP), first got involved with the MOHC in 2014 through a partnership that funded a local GHP Oral Health Coalition to serve residents of Flint and Genesee County. The local coalition was a response to Michigan's Medicaid expansion. With dental services opened up to a greater number of Genesee County adults, a need to boost awareness and connection among those residents and providers was a must. Milanowski also serves as MOHC's board president.
"All these new people had dental insurance, so it was really bringing everybody together to talk and make sure that they were aware," Milanowski says. "We have
Mott Children’s Health Center,
Mott Community College Dental School, private providers, and a number of organizations like ourselves as well as the two major dental insurance providers for Medicaid in our state, Delta Dental and Blue Cross Blue Shield."
This year, the GHP Oral Health Coalition will host the
Michigan Dental Association Foundation’s fifth Mission of Mercy event at Flint’s Dort Financial Center on June 14 and 15. The two-day free clinic treats under-served and uninsured patients of all ages, meeting their most urgent dental needs.
"This is for people who need dental work, whether it's cleanings, fillings, extractions, and we're hosting it here with our local coalition," Milanowski says. "It's a statewide effort. They're expecting to offer 2,000 people dental care."
The local coalition is also tackling dental care for older adults with Medicare plans that do not include dental benefits, and helping people with hearing and vision disabilities receive treatment.
"You can imagine how terrifying it is to go to a dentist's office, and you can't see your interpreter or hear when that drill is going," Milanowski says. "We've been working with local communities that are working with this population and have created videos and other materials on dental procedures, so they know what to expect at the dentist’s office."
Milanowski is proud of MOHC's work to make dental services available to more Michiganders, from kindergarteners getting their first dental screening to providers receiving higher Medicaid reimbursement for services so they can accept Medicaid patients without losing money. Moving forward, he has high hopes for building equity among both patients and providers.
"Talking about equity, one of the areas that needs to be improved is having more people of color be practitioners. That's a huge issue," he says. "People obviously are more comfortable with providers that look like them. So, that's another issue we're addressing as a strategic initiative as we approach increasing the workforce."
Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children's books. You can contact her at [email protected] or www.constellations.biz.
Kimberly Singh photos by Tommy Allen. All other photos courtesy of the subjects.