TennCare dental benefits are handled by a contracted dental benefits manager. TennCare's current dental benefits manager is DentaQuest.
Do you have questions about dental benefits not answered here? Call DentaQuest (toll free) at 1-855-418-1622.
Effective January 1, 2023, all adult TennCare members have dental benefits. Adult members are now able to see a dentist at no cost to them for all medically necessary, covered dental services, which consist of regular exams, x-rays, cleanings, fillings, crowns, and more.
The list of covered procedure codes is posted and will be maintained on this website. TennCare’s Adult Dental Plan is managed by the current dental benefits manager, DentaQuest.
Members may contact DentaQuest at 1-855-418-1622 for any questions regarding their dental benefits or dental providers or visit Find a Dentist | State Plans | Medicaid | Medicare | CHIP - DentaQuest (https://dentaquest.com/find-a-dentist-gov/) - The website includes a "Find a Dentist Tool."
The adult pregnancy and postpartum dental benefit merged with the adult dental benefit on January 1, 2023. All adult members are now eligible for the same adult dental benefits and coverage. Members have access to all medically necessary, covered dental benefits.
ECF and 1915(c) waiver members will still be eligible for the same dental benefits, but the dental services covered under the new Adult Dental Benefit will no longer count against the member’s HCBS cost cap/expenditure cap. Only the waiver-funded dental services (those not covered by the Adult Dental Benefit) will count against a member’s cost cap/expenditure cap.
Beginning January 1, 2023, TennCare will cover dental services for all adults enrolled in TennCare, including TennCare members located in nursing facilities. For adult members in a nursing facility or ICF/IID needing dental care, dental benefits will be available through DentaQuest.
For more information about coordinating dental services for members in a nursing facility or ICF/IID, contact DentaQuest at 1-855-418-1622. Because members will have dental benefits, after January 1, 2023, dental expenses should not be submitted as Incurred Medical Expenses (IME) to offset Patient Liability. Any requests for dental services must be submitted to DentaQuest. In some cases, denied requests may be eligible as IME, but will be reviewed on a case-by-case basis and only after DentaQuest denial of coverage. Please note: dental codes/services covered by the adult dental benefit will not be allowed as IME.
Adult Dental Frequently Asked Questions by Members in Nursing Facilities with IME deductions
Comprehensive dental services are available to children as medically necessary. Parents are encouraged to bring their children in to see a dentist for routine care.
Orthodontic treatment (braces) is provided to children diagnosed with a handicapping malocclusion (go to definition in the Public Necessity Rules). Even if your general dentist thinks braces would improve your child's smile, this is considered cosmetic treatment and is not paid for by TennCare.
Adult pregnant and postpartum members will receive the same benefits and coverage as all adult members, as of January 1, 2023. Members will have access to all medically necessary, covered dental benefits.
Community Water Fluoridation
Teeth are made stronger and less likely to get cavities just by drinking tap water with fluoride. Fluoride is found naturally in soil, water, and food. Studies and research shows that water with the right amount of fluoride has been proven safe and effective in preventing cavities in both children and adults. To learn more, please visit: http://tn.gov/health/health-program-areas/oralhealth/professionals/oralhealth-cwf.html
Most cavities found in the teeth of children could have been prevented by using dental sealants. A dental sealant is a thin plastic coating applied to the grooves of the chewing surfaces of the back teeth to protect them from cavities. Ask your dentist about dental sealants at your next visit.
Silver Diamine Fluoride (SDF)
Did you know there is a new, quick, and easy way to stop cavities from getting bigger without shots or drills? Silver Diamine Fluoride (SDF) is an odorless liquid applied directly to cavities with a small brush. Ask your dentist about silver diamine fluoride at your next visit. Learn more at http://centerforevidencebasedpolicy.org/wp-content/uploads/2018/06/SDF-Patient-Fact-Sheet-FINAL.pdf
Age 1 Dental Visit
Many parents and caretakers don’t know that cavities can start early in the mouth of a baby. A cavity can start to develop shortly after the first tooth grows in, and can spread quickly. The first dental exam is recommended when the first tooth grows in, or no later than the first birthday. Children should then go to the dentist twice a year after the first appointment.
Members may contact DentaQuest at 1-855-418-1622 for any questions regarding their dental benefits or dental providers or visit Find a Dentist | State Plans | Medicaid | Medicare | CHIP - DentaQuest (https://dentaquest.com/find-a-dentist-gov/) - The website includes a "Find a Dentist Tool.
Since 2001, the Tennessee Department of Health has had a grant agreement with TennCare.
This grant is for oral disease prevention services for grade school children (K-8) in public schools. Where approximately 50 percent or more of the student population participates in the school lunch program. This also includes referral of underserved children with unmet dental needs to dental providers.
For more information, please visit the Tennessee Department of Health.