Under AHCCCS, medically necessary dental services for children can include tooth extractions. Prior authorization is needed before your child’s dentist can perform a tooth extraction covered by AHCCCS.
At the Kids Dental Office of Phoenix, our pediatric dentists accept patients covered by AHCCCS insurance providers. In this blog post, we consider specifically how AHCCCS pays for medically necessary tooth extraction costs and briefly describe tooth extraction procedures.
To learn more about child tooth extractions and whether your family can be covered by AHCCCS for dental care services, call our office at (602) 903-4894 or contact us online.
How Does AHCCCS Cover Child Tooth Extractions in Arizona?
A child covered by AHCCCS will undergo an Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) oral health screening by his or her primary care provider. After this screening, the primary care provider refers the child for urgent or routine dental care.
Under EPSDT, children and adolescents are entitled to receive the following dental services:
- Routine dental exams and checkups
- Preventive services such as cleanings, fluoride treatments, and sealants
- Diagnostic X-rays to identify cavities and other oral issues
- Fillings and restorations for tooth decay
- Medically necessary orthodontics (such as braces for severe malocclusion)
- Emergency services, including treatment for infections and trauma
Tooth extractions for symptomatic (including pain), infected, or non-restorable primary or permanent teeth are considered emergency dental services under EPSDT.
Generally, under your child’s AHCCCS insurance policy, you can self-refer your child to a dental home, which is a dentist’s office, such as the Kids Dental Office of Phoenix, as long as the dental office is included in the insurer’s network.
What Kinds of Extractions Does AHCCCS Cover?
Types of extractions that AHCCCS covers under EPSDT include:
- Extractions of erupted teeth or exposed roots (Dental code D7140 – this is usually considered a routine extraction)
- Removal of impacted teeth (Dental codes D7220, D7230, D7240, D7241)
- Surgical removal of erupted teeth (Dental code D7210)
- Surgical removal of residual tooth roots (Dental code D7250)
Oral surgeries usually require pre-approval from AHCCCS before they will be paid for.
The Tooth Extraction Process
If your child needs a tooth extraction, the process involves the following steps.
Taking an X-ray
The first step in a tooth extraction is X-ray imaging of the tooth and surrounding teeth and gum tissue. This way, we will know in advance whether any possible complications may exist that can affect the extraction procedure.
Administering Local Anesthesia
For your child’s comfort during the extraction, we will apply a local anesthetic to the extraction site.
- First, the dentist will apply a topical gel to numb the tissue around the injection site.
- Next, the dentist will administer a numbing injection.
Typically, general anesthesia, such as nitrous oxide, is not necessary for a simple extraction.
Tooth Removal
Once the tooth is sufficiently numb, the dentist will remove the tooth, taking care not to damage any surrounding bone during the extraction.
Compression and Possible Application of Oral Stitches
Once the tooth is removed, the dentist will apply compression, which promotes healing by forming a blood clot at the extraction site. If necessary, the dentist may also place stitches into the gum at the extraction site.
Possible Spacer Installation
It may be necessary to put a space maintainer into the gap left by the extracted tooth. We use spacers on a case-by-case basis, depending on the tooth removed and the progression of your child’s permanent teeth.
What to Expect After the Extraction
The healing time for gums after a tooth extraction varies. Initial gum healing typically takes one to two weeks, during which the socket begins to close and new tissue forms.
While the gum tissue is healing around the extraction site, your child should eat soft foods and avoid drinking through a straw or engaging in vigorous mouth rinsing, as this can loosen the blood clot.
In some cases of tooth extraction aftercare, we may prescribe an antibiotic to help prevent infection. An oral anti-inflammatory pain reliever may also be necessary. Icing the site may keep your child more comfortable, especially if stitches are used.
After two or three weeks, the hole left by the extraction is nearly closed, and gum tissue has significantly healed. Complete healing of the gum tissue, including the disappearance of any indentation, takes about 3 to 4 weeks. Larger teeth, like wisdom teeth or molars, may take longer to fully heal.
Do You Have Questions About AHCCCS and Child Tooth Extraction?
At the Kids Dental Office of Phoenix, we accept AHCCCS insurance for child dental care, including pediatric tooth extractions. We can help you determine whether your family is eligible for AHCCCS coverage and guide you to resources that will assist you in the application process.
If you cannot qualify for AHCCCS coverage, you may be eligible for KidsCare, which is Arizona’s program that administers the federal Children’s Health Insurance Program (CHIP) for families with incomes too high to qualify for Medicaid but are also too low to afford out-of-pocket payment options or private health or dental insurance plans.
To speak with one of our experienced and caring Phoenix pediatric dentists, call us at (602) 903-4894. Alternatively, you can use our online contact form to reach out to us.