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State
Coverage
Alabama
  • Dental check-up and dental cleaning every 6 months
  • X-rays, fillings, extractions, root canals, stainless steel crowns
Alaska
  • Dental exam covered twice a year beginning at age 3
Arizona
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
Arkansas
  • Prophylaxis covered 1 time per fiscal year (more as medically necessary)
  • Sealants once per lifetime on 1st and 2nd molars
California
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
Colorado
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
    Complete a radiographic assessment of pathology/abnormal growth and development as indicated
Connecticut
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
Delaware
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
District of Columbia
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
Florida
  • Oral exam, prophylaxis, and topical fluoride every 6 months
  • Sealants one per tooth every 3 years
  • Bitewings every 6 months
  • Panoramic x-rays once per year
  • Complete intraoral x-rays once in 3 year period
Georgia
  • Prophylaxis twice a year
  • One comprehensive oral evaluation and one periodic oral evaluation per calendar year
  • Panoramic x-rays or full series x-rays once every 3 years (panoramic x-rays limited to those over 5 years of age)
Hawaii
  • Oral exam, prophylaxis, and topical fluoride 2x/year (starting at age 1)
  • Sealants for 1st and 2nd permanent molars
  • Bitewings x-rays 2x/year
  • Full-series x-rays every 3 years
  • Panoramic x-rays every 2 years
Idaho
  • Prophylaxis and topical fluoride every 6 months
  • Periodic oral evaluation every 6 months; comprehensive oral evaluation every 12 months
  • Intraoral x-rays once in 36 month period
  • 4 bitewings (total) every 6 months
Illinois
  • Prophylaxis every 6 months
  • Clinical oral evaluation every 12 months
  • Complete set of x-rays every 3 years
Indiana
  • Regular assessments and preventative care every 6 months
Iowa
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
Kansas
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
Kentucky
  • Comprehensive oral exam once a year
  • 4 bitewings per year
  • Prophylaxis covered once a year
  • Sealants of 6 and 12 year molars every 4 years (3 per lifetime)
Louisiana
  • Oral evaluation, topical fluoride, prophylaxis, and bitewings covered once per year
Maine
  • Comprehensive oral exam 2x/year
  • Prophylaxis and fluoride 2x/year
  • Sealants for permanent teeth once every 3 years
Maryland
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
Massachusetts
  • Prophylaxis and fluoride 2x/year (no sooner than 6 months)
  • Bitewings 2x/year
  • Intraoral bitewings (complete set) once every 3 years
  • Sealants on 1st and 2nd molars once every 3 years
Michigan
  • Prophylaxis covered every 6 months
  • Periodic oral evaluation every 6 months
  • Complete series of x-rays every 5 years
  • Bitewings every 12 months
Minnesota
  • Unclear: State documents call for verbal referral from medical screener to a dentist at age 3 or earlier if indicated and include summary of AAPD guidelines as “Other Professional Recommendations”

Mississippi
  • Prophylaxis 2x/year
  • Comprehensive exams 2x/year
  • Comprehensive x-rays every 2 years
  • Sealants covered only for 1st and 2nd molars
Missouri
  • Prophylaxis 2x/year (starting at 6 months of age)
Montana
  • Oral exam and prophylaxis every 6 months
Nebraska
  • Periodic oral evaluations every 6 months
  • Prophylaxis every 6 months
  • Fluoride at provider suggestion
  • Intraoral complete series every 3 years
Nevada
  • Complete exam and cleaning 2x/year (fluoride covered)
New Hampshire
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
New Jersey

Up to age 17:

  • Prophylaxis and fluoride every 6 months
  • Comprehensive dental exam every 6 months

Age 17 and older:

  • Prophylaxis and fluoride every 12 months
  • Comprehensive dental exam every 12 months
New Mexico
  • Periodic oral exam every 6 months
  • Prophylaxis every 6 months
  • Complete intraoral x-rays every 3 years
  • Bitewings every 12 months
New York
  • Prophylaxis and fluoride every 6 months
  • Complete intraoral x-rays every 3 years
  • Bitewings every 6 months
  • Sealants between 5 and 15 years of age, reapplication every 3 years
North Carolina
  • Routine dental exam every 6 months (earlier as indicated)
North Dakota
  • Prophylaxis 2x/year· Panoramic films every 5 years
Ohio
  • Prophylaxis and fluoride every 6 months
  • Comprehensive oral exam every 6 months
Oklahoma
  • Prophylaxis with or without fluoride 2x/year
  • Dental exams 2x/year
  • Bitewings 2x/year (beginning at age 3)
Oregon
  • Scale and clean teeth every 6 months
  • Topical fluoride every 6 months
  • Sealants as needed
Pennsylvania
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
Rhode Island
  • Semi-annual coverage of dental exams, cleaning, and fluoride treatment
South Carolina
  • Cleaning, x-rays, and topical fluoride every 6 months
South Dakota
  • Prophylaxis and topical fluoride 2x/12 months
  • Initial or periodic oral exam 2x/12 months
  • Bitewings (single, two, four films) 2x/12 months
  • Sealant-per tooth, limited to 1st and 2nd molars only once every 3 years
Tennessee
  • Scale and clean teeth every 6 months (as indicated by patient’s needs)
  • Topical fluoride every 6 months (or as indicated)
  • Complete a radiographic assessment of pathology/abnormal growth and development as indicated
Texas
  • Routine dental check-up services available for eligible recipients one year of age or older every 6 months
  • Preventive dental services include prophylaxis, topical fluoride, dental sealants, oral nutritional counseling and fixed or removable space retainers
Utah
  • Prophylaxis with or without fluoride 2x/year
Vermont
  • Oral exam 2x/year
  • Prophylaxis and fluoride 2x/year
  • Complete intraoral x-rays once every 3 years
Virginia
  • Periodic oral examinations, prophylaxis, and fluoride covered every 6 months under age 21
  • Sealants covered once per tooth (anterior teeth, 3rd molars, or premolars not covered)
Washington
  • Periodic oral exam once every 6 months
  • Intraoral x-rays once in 3 year period
  • Bitewings: total of 4 allowed every 12 months· Topical fluoride once every 6 months
West Virginia
  • Periodic oral exam every 6 months
  • Prophylaxis and topical fluoride once every 6 months
  • Single film bitewings 4x/year
Wisconsin

0-12:

  • Periodic oral exam every 6 months
  • Prophylaxis with topical fluoride every 6 months
  • Complete x-rays once every 3 years, regional intraoral x-rays every 6 months

Over 12:

  • Period exam once a year (up to 2 more exams per year with HealthCheck referral)
  • Topical fluoride once a year
  • Sealants on 1st and 2nd molars once per 3 year period (certain teeth covered without prior approval)
Wyoming
  • Prophylaxis and topical fluoride once every 6 months (more if medically necessary)

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