I need dental care I can afford

Since April 2023, New Hampshire Medicaid covers dental care for adults, not just children. The program is called NH Smiles and is administered by DentaQuest. Here is what that means in practice.

• Adults (21+):If you have full Medicaid, you're enrolled automatically and receive a DentaQuest ID card in the mail — you don't have to sign up.
• What's covered: exams and x-rays, cleanings, fillings, limited gum (periodontal) treatment, tooth extractions and other oral surgery, and anesthesia. Coverage also includes a ride to your dental appointment and help managing your care.
• Annual maximum: the plan pays up to $1,500 per yeartoward your dental care. Preventive and diagnostic visits (checkups, cleanings, x-rays) don't cost you anything.
• Small cost-sharing can apply to non-preventive work if your income is above the federal poverty level — capped so it never exceeds 5% of your household income.
• Dentures are covered for people on the DD, ABD, or Choices for Independence (CFI) waivers, and for nursing-facility residents.
• Children and youth (birth through 20) have long had full dental coverage under Medicaid. To find a dentist who takes Medicaid for your child, call NH DHHS at 1-844-275-3447 (1-844-ASK-DHHS).

If you don't have Medicaid or dental insurance, you still have real options in New Hampshire. Costs are based on your income, and some care is free.

• Community health center dental (sliding scale).NH's community health centers — including Greater Seacoast Community Health (Families First in Portsmouth, Goodwin in Somersworth) and others statewide — offer full dental care on a sliding fee scale. Start at getcommunityhealth.org or dial 211.
• NHTI Dental Hygiene Clinic (Concord). Very low-cost cleanings, x-rays, and prevention from supervised students. Call 603-230-4023. (Note: New Hampshire has no dental school, so there's no student dentist clinic for fillings — the hygiene clinic covers cleanings and prevention only.)
• Donated Dental Services (DDS)from the Dental Lifeline Network provides free, comprehensive treatment to people who have a permanent disability, are 65+, or are medically fragile and can't afford care. Learn more at dentallifeline.org/new-hampshire.
• NH Dental Society's low-cost care list is a maintained directory of reduced-cost programs across the state: nhds.org.
• Veterans: New Hampshire's Veterans' Freedom to Smile initiative connects uninsured veterans to donated dental care. Ask at nhveterans.nh.gov.

Children get more dental coverage than adults, and prevention starts early.

• NH Medicaid covers kids fully from birth through age 20 — checkups, cleanings, fillings, sealants, and more. If your child has Medicaid and you need a dentist, call 1-844-275-3447.
• NH Healthy Kidsis New Hampshire's low-cost health coverage for children in families who earn a bit too much for Medicaid; it includes dental. Learn more and apply through NH DHHS.
• School and community programs bring cleanings, screenings, and sealants to many NH schools and Head Start sites. Ask your school nurse.
• The Children's Dental Network helps families find a dentist for kids, including those with special health needs: childrensdentalnetwork.org.

This group faces the toughest dental gaps — but there are specific NH doors.

• Medicare does not cover routine dental.Original Medicare won't pay for cleanings, fillings, or dentures. Some Medicare Advantageplans add limited dental — check your specific plan's benefits.
• If you also have Medicaid (many older and disabled adults do), the NH Smiles adult benefit above applies — including dentures for people on the DD, ABD, or CFI waivers and nursing-facility residents.
• Donated Dental Services specifically serves people 65+ or with a permanent disability (see the waitlist note above).
• Getting there: if you have Medicaid, your ride to the dentist is covered. See our guide to medical transportation in NH.

A toothache at 2 a.m. is miserable, and it's not always clear where to turn. Here's the plain version.

• Emergency room— go if there's facial swelling spreading toward the eye or neck, trouble breathing or swallowing, a high fever, heavy bleeding, or a broken jaw. ERs treat infection and pain (antibiotics, pain relief) and rule out danger — but they usually can'tfix or pull the tooth. That's a follow-up with a dentist.
• Urgent dental (no danger signs) — for a bad toothache, broken tooth, or lost filling, call the DentaQuest line (877-248-6684 if you have Medicaid) or a community health center and ask for the soonest urgent slot. Teledentistry (866-302-0905) can help you decide overnight.
• Knocked-out permanent tooth — this is time-sensitive. Handle it by the crown (not the root), keep it moist (milk or inside the cheek), and get to a dentist or ER within about an hour.

Dental plans use a handful of terms that trip everyone up. Here is the whole picture, in plain language — whether you're looking at a plan through work, the Marketplace, or just trying to read the one you have.

• It's usually separate from medical insurance. Dental is typically its own plan with its own card, premium, and rules — even when the same company sells both.
• Premium — what you pay each month to have the plan, whether or not you go to the dentist.
• Deductible — a set amount you pay out of pocket before the plan starts paying (often waived for cleanings and checkups).
• The “100 / 80 / 50” pattern. Most plans pay 100% of preventive care (cleanings, exams, x-rays), ~80% of basic work (fillings), and ~50% of major work (crowns, root canals, dentures). You pay the rest — that share is called coinsurance.
• Annual maximum — the catch that surprises people. This is the most the plan will pay in a year, commonly around $1,000–$2,000. It's the opposite of medical insurance: once you hit the max, you pay 100% of anything more that year. Big work is often split across two calendar years to use two annual maximums.
• Waiting periods— many plans make you wait (often 6–12 months) before they'll cover major work, so you can't buy a plan the week before a crown. Preventive care usually starts right away.
• In-network vs. out-of-network— “in-network” dentists agreed to the plan's lower rates, so you pay less. Out-of-network dentists can charge more, and the plan may pay a smaller share. Always ask a dentist's office “are you in-network for my plan?” before you go.