Dental Services
A Dental Home is a dentist—either a general dentist or a pediatric dentist—who provides ongoing dental care for your child. This is the main dentist your child will see for regular checkups, cleanings, and most dental treatments. If your child needs more advanced care, the Dental Home can refer you to a dental specialist.
As a DentaQuest member, your child is assigned a Dental Home. This is the dentist you will visit regularly. Your Dental Home will get to know your child’s needs and help them maintain good oral health. It's important to return to the same Dental Home for each appointment to ensure consistent care.
Your Dental Home Will Provide:
- Complete dental care
- A personalized dental health plan
- Advice on growth and diet
- Guidance on proper oral hygiene
Healthy teeth and gums are essential for overall well-being. Regular dental checkups every six months help ensure a longer, healthier life.
Members may contact DentaQuest at 1-855-418-1622 for any questions regarding their dental benefits or dental providers or can visit DentaQuest’s website link: Find a Dentist
Dental care is very important for your child’s health and well-being! Comprehensive dental services are available to children as medically necessary and provided until they reach age 21. Parents are encouraged to bring their children in to see a dentist for routine care. Children should visit the dentist by their first birthday or with the eruption of their first tooth.
Covered Benefits include:
- Oral Health Screenings
- Examinations of the teeth & oral cavity
- X-rays & other diagnostic services
- Dental Cleanings
- Topical Fluoride
- Application of Dental Sealants
- Fillings & Crowns
- Braces*
- Root Canals & Extractions
- Gum health Services
- Oral Cancer Screenings
- Sedation
For more information, visit our Childrens Dental Covered Codes list.
*Orthodontic treatment (braces) is provided to children diagnosed with a handicapping malocclusion (definition is provided in the Rules of The Tennessee Department of Finance and Administration Bureau of TennCare). 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.
Members may contact DentaQuest at 1-855-418-1622 for any questions regarding their dental benefits or dental providers or can visit DentaQuest’s website link: Find a Dentist
CoverKids offers dental coverage for eligible children up to age 19. Benefit Levels for Group One Child and Group Two Child include low copays and out-of-pocket maximums. There are no copays for routine preventive services like oral exams, x-rays, and fluoride treatments. Additionally, there are no dollar limits on comprehensive care or orthodontics—any medically necessary treatments are fully covered.
Covered Benefits include:
- Oral Health Screenings
- Examinations of the teeth & oral cavity
- X-rays & other diagnostic services
- Dental Cleanings
- Topical Fluoride
- Application of Dental Sealants
- Fillings & Crowns
- Braces*
- Root Canals & Extractions
- Gum health Services
- Oral Cancer Screenings
- Sedation
For more information, visit our CoverKids Dental Covered Codes list.
*Orthodontic treatment (braces) is provided to children diagnosed with a handicapping malocclusion (definition is provided in the Rules of The Tennessee Department of Finance and Administration Bureau of TennCare). 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.
Members may contact DentaQuest at 1-855-418-1622 for any questions regarding their dental benefits or dental providers or can visit DentaQuest’s website link: Find a Dentist
All adult TennCare members have dental benefits at no cost to them for all medically necessary, covered dental benefits.
Covered Benefits include:
- Oral Health Screenings
- Examinations of the teeth & oral cavity
- X-rays & other diagnostic services
- Dental Cleanings
- Topical Fluoride
- Application of Dental Sealants
- Fillings & Crowns
- Root Canals & Extractions
- Gum health Services
- Oral Cancer Screenings
For more information, visit our Adult Dental Covered Codes list.
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.
Members may contact DentaQuest at 1-855-418-1622 for any questions regarding their dental benefits or dental providers or can visit DentaQuest’s website link: Find a Dentist
January 1, 2023, dental services provided under the new Adult Dental Benefit no longer apply toward the member's HCBS cost cap or expenditure cap. Only dental services funded through the waiver—those not included in the Adult Dental Benefit—will count against the member’s cost or expenditure cap.
Members may contact DentaQuest at 1-855-418-1622 for any questions regarding their dental benefits or dental providers or can visit DentaQuest’s website link: Find a Dentist
Adult pregnant and postpartum members receive the same benefits and coverage as all adult members. Members have access to all medically necessary, covered dental benefits.
Members may contact DentaQuest at 1-855-418-1622 for any questions regarding their dental benefits or dental providers or can visit DentaQuest’s website link: Find a Dentist
Since 2001, the Tennessee Department of Health has maintained a grant agreement with TennCare to support oral disease prevention services for grade school children (K–8) in public schools. This program primarily targets schools where approximately 50% or more of the student population participates in the National School Lunch Program, indicating a high level of economic need.
Services provided under the grant include preventive dental care and education, as well as referral of underserved children with unmet dental needs to appropriate dental providers.
For more information, please visit the Tennessee Department of Health.
Please call DentaQuest at 1-855-418-1622 for questions about your dental benefits or dental providers. To check if your dentist is a participating provider with TennCare’s Children or Adult Dental Plan, please visit DentaQuest’s Find a Dentist
DentaQuest will not send a card. Members should be instructed to show their TennCare member ID card at the time of service for proof of coverage or the ID card of their medical plan.
When the member is eligible for dental benefits, they will receive a welcome packet from DentaQuest. The member should make sure the address in TennCare Connect is correct.
Dentists who accept TennCare cannot balance bill. A dentist who provides care to TennCare members agrees to accept the TennCare fee as payment in full. TennCare will only pay for services up to the TennCare fee, minus whatever is covered by your primary insurance.
Your Medicaid dental benefit is the payer of last resort. Your dentist will need to first submit your claim to your primary dental insurer, such as your Medicare Advantage plan. After the primary has paid out, your provider will submit the claim to DentaQuest for any remaining payment. Your dentist will send your EOB from your primary insurer to DentaQuest showing how much they paid.
Dual members should not have out-of-pocket expenses for TennCare covered services. Providers may not collect a primary co-pay from a TennCare member.
They should call their Medicare Advantage plan first, as that is their primary insurance.
For more information on who qualifies for TennCare or to learn more about eligibility, please visit TennCare’s eligibility webpage.
Members may contact DentaQuest at 1-855-418-1622 for any questions regarding their dental benefits or dental providers or can visit DentaQuest’s website link: Find a Dentist
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 show 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: TN Department of Health’s Community Water Fluoridation website.
Dental Sealants
Most cavities found in the teeth could have been prevented by using dental sealants. A dental sealant is a thin, protective 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. The fluoride in SDF boosts tooth strength by demineralizing the enamel, or top layer of the tooth. Ask your dentist about Silver Diamine Fluoride at your next visit. Learn more at Center for Evidence Based Policy’s Silver Diamine Fluoride Patient Fact Sheet.
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.