Oklahoma Medicaid Dental Coverage

Updated August 2026

Adult SoonerCare members are covered under OHCA's "Adult Limited Dental Benefit." Contrary to a common misconception, this benefit does include routine preventive care — cleanings with fluoride are covered once every six months, and oral exams are covered on a regular schedule. The benefit is "limited" mainly because two higher-cost services, root canals and crowns, are not covered for adults (they remain covered for members under 21).

Limited

Adult dental tier

Comprehensive

Children's dental (under 21)

1-800-987-7767

OHCA member line

SoonerCare adult dental coverage is limited — children receive comprehensive dental

Adult SoonerCare members receive the "Adult Limited Dental Benefit," which covers preventive care, cleanings, fillings, extractions, dentures, and periodontal treatment, but not root canals or crowns. Comprehensive dental care, including orthodontics when medically necessary, is fully covered for members under age 21 through the federal EPSDT mandate. Contact your SoonerSelect health plan or OHCA at 1-800-987-7767 to confirm specific dental coverage for your plan.

Adult dental coverage under SoonerCare

Several services under the Adult Limited Dental Benefit require prior authorization, including full and partial dentures and periodontal scaling and root planing. Fillings are limited to one permanent restoration per tooth every 24 months, and dentures are limited to once every five years for adults under 25 and once every seven years for adults 25 and older. Adult members enrolled in SoonerSelect managed care plans should confirm dental coverage directly with their plan by calling the member services number on their SoonerSelect card.

  • Oral exams — comprehensive, periodic (every six months), and limited evaluations
  • X-rays and other diagnostic imaging
  • Cleanings with fluoride — limited to once every six months
  • Tobacco cessation counseling — up to eight sessions per year for documented tobacco use
  • Fillings — silver and tooth-colored, limited to one restoration per tooth every 24 months
  • Medically necessary extractions
  • Full and partial dentures — prior authorization required; limited to once every five years (under 25) or seven years (25 and older)
  • Periodontal scaling and root planing — prior authorization required
  • Medical and surgical services performed by a dentist or physician

Children's dental coverage — comprehensive under EPSDT

Children and young adults under age 21 enrolled in SoonerCare receive comprehensive dental coverage under the federal EPSDT mandate (Early and Periodic Screening, Diagnostic and Treatment, 42 U.S.C. § 1396d(r)). Per OHCA and federal EPSDT requirements, covered dental services for SoonerCare members under 21 include the following.

  • Routine dental examinations and cleanings
  • Dental X-rays at regular intervals
  • Fluoride treatments and dental sealants for cavity prevention
  • Fillings — amalgam and tooth-colored composite
  • Tooth extractions — simple and surgical
  • Root canal treatment for primary and permanent teeth when medically necessary
  • Space maintainers following early tooth loss
  • Orthodontic treatment when medically necessary for functional correction
  • Emergency dental services for pain, infection, or trauma

Finding a SoonerCare dentist in Oklahoma

SoonerCare members can search for in-network dental providers through OHCA's provider search tool at oklahoma.gov/ohca, or through their SoonerSelect plan's member portal. SoonerSelect members should use their plan's provider directory to find dentists who participate in both SoonerCare and their specific managed care plan.

  • Check your SoonerSelect plan's provider directory at the plan's website or through your plan's member services line
  • Use the OHCA provider search at oklahoma.gov/ohca for fee-for-service SoonerCare members
  • Call OHCA at 1-800-987-7767 if you need help finding a participating dentist
  • Federally Qualified Health Centers (FQHCs) throughout Oklahoma accept SoonerCare and often offer dental services — find one at findahealthcenter.hrsa.gov

Oklahoma's rural and frontier counties face significant dental provider shortages. FQHCs in underserved communities provide a critical safety net. The Oklahoma Primary Care Association at okpca.org maintains a list of community health centers statewide.

Dental coverage for seniors on SoonerCare

SoonerCare members who are also enrolled in Medicare (dual-eligibles) face a specific dental gap: traditional Medicare Part A and B do not cover routine dental, and SoonerCare's adult dental benefit is limited. Senior Oklahomans enrolled in both programs can check whether a Medicare Advantage plan in their area offers dental benefits that would supplement SoonerCare's limited coverage. The Oklahoma Insurance Department (oid.ok.gov) and the State Health Insurance Assistance Program (SHIP) at 1-800-763-2828 provide free counseling on this topic.

Oklahoma Health Care Authority (SoonerCare)

  • OHCA member services: 1-800-987-7767
  • Adult Limited Dental Benefit Member Guide: oklahoma.gov/ohca/individuals/soonercare-dental.html
  • OHCA provider search: oklahoma.gov/ohca
  • Oklahoma Primary Care Association: okpca.org
  • SHIP counseling (Medicare/Medicaid seniors): 1-800-763-2828
Visit the official Oklahoma Medicaid website

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