Every 14 seconds, an American ends up in the emergency room for a dental problem that might have been prevented. These visits are painful for patients and costly for the healthcare system, yet they persist because routine dental care remains out of reach for millions, including many in Connecticut. The state’s Medicaid program provides only limited dental coverage for adults, leaving low-income residents without access to basic preventive and restorative services. The result is predictable: untreated caries progress into infections, manageable conditions escalate into emergencies, and patients turn to hospital emergency departments for relief. There, they often receive only temporary solutions like antibiotics or pain medication rather than definitive care. This is not just a coverage gap. It is a system failure. Andja Demiraj Across the United States, dental-related emergency department visits cost roughly $2.4 billion each year. These visits are far more expensive than routine dental care and do little to resolve the underlying issue. By delaying treatment until it becomes urgent, the system creates higher costs and worse outcomes, a pattern Connecticut continues to replicate. The burden falls disproportionately on those who can least afford it. Medicaid enrollees experience higher rates of untreated decay and periodontal disease, conditions that are not only painful but also closely linked to chronic illnesses such as diabetes, cardiovascular disease, and Alzheimer’s disease down the line. Oral health is not separate from overall health, but foundational to it. Yet policy continues to treat it as separate or optional. Expanding adult Medicaid dental benefits would address both the inequity and the inefficiency. When coverage is expanded, preventive care increases. The conditions are identified earlier, treated more effectively and at lower cost, and far less likely to result in emergency visits. In other words, the state can spend less in the long run by investing more upfront. With that said, coverage alone will not solve the problem. A major barrier in Connecticut is provider participation. Medicaid reimbursement rates for dental services have historically lagged behind, discouraging providers from accepting Medicaid patients. Without addressing this constraint, expanded coverage risks becoming an empty promise of benefits that exist on paper but not in practice. A more effective approach would pair expanded coverage with targeted strategies to strengthen provider participation. This includes increasing reimbursement for high-need services, reducing administrative burdens, and offering incentives such as loan repayment for providers serving Medicaid populations (regardless of dental specialty) would help ensure that access expands alongside coverage. The state should also take a phased approach. Prioritizing preventive and basic restorative services like exams, cleanings, fillings and extractions would target the most common and preventable conditions while managing costs. To add, beginning with high-need communities would allow Connecticut to monitor utilization, assess provider response, and refine the program before scaling it statewide. Critics will point to the upfront costs, particularly in a constrained fiscal environment. They are not wrong: addressing years of unmet need will require investment. However, focusing only on short-term spending misses the larger reality. Preventive care reduces long-term costs by avoiding expensive hospital visits and advanced treatments. The question is not whether Connecticut will pay, but whether it will pay more later for worse outcomes. For too long, oral health has been treated as separate from the rest of healthcare. That separation has consequences: higher costs, poorer outcomes and deepening inequities. Hospitals, community health centers, and patients all stand to benefit from a policy adjustment and investment into more preventative dental care. Connecticut has the opportunity to take a more efficient and equitable path forward. Andja Demiraj attends Yale University and lives in Middlebury. ...read more read less