As Medicaid expanded dental coverage, a local team of leaders saw the chance to serve those previously overlooked
By Kristen De Deyn Kirk
Photos By Will Hawkins
In 2021, Carl Edmonds, a retired behavioral health care administrator, heard about Medicaid coverage improving in Virginia. Friend and business partner Shane August shared an article about a planned expansion, and an idea was born: Opening a dental practice serving everyone, including individuals with Medicaid. With the governmental insurance program growing, adults would finally qualify for dental care.
“I’ve always been in the business of helping people,” Edmonds says, “particularly those individuals who are disenfranchised, who may not be able to get services or may be on a long waiting list. We saw this as an opportunity to continue serving the population.”
He, August and two other partners—one a dentist—searched for an easily accessible office. They chose Downtown Norfolk on East City Hall Avenue, in front of a bus stop and around the corner from a Tide light rail station. Two dentists, two hygienists and a receptionist came on board, and ReStore Dental Center of Hampton Roads, PC opened in late summer 2022.
High on Edmonds’ priority list: Making people feel welcome. The practice space is modern and light, with glass all around and high ceilings. Sunshine floods in, and plants, music and the option to sip on tea put patients at ease.
“It feels like you might be coming to a spa when you come here,” Edmonds says with a laugh as he describes the practice.
Care is provided in private areas, of course, as the ReStore team preserves patients’ dignity. Patients’ rights—including honesty from the staff; a discrimination-free environment; and education about dental health—are posted on the wall. The setting and the service should always be patient-focused, Edmonds says.
He worries about patients’ self-esteem. Some patients do not smile, barely opening their mouths as they speak. Feeling uncomfortable, the patients may not seek new relationships and new job opportunities. ReStore can help those individuals with both medical and cosmetic concerns.
“Once their issues have been addressed,” he says, “with the confidence that people have, [they] go out; they can communicate more; they smile more; and they can gain employment as a result.”
Medicaid services provides a list of dentists like the ReStore team who treat patients. Unfortunately, the list isn’t always long enough. Sometimes dentists don’t realize they can now be partially reimbursed for services delivered to adult patients with Medicaid, so they don’t sign up to be a provider. Or they are unsatisfied with the reimbursement rate—which stands at 30%. While better than the former rate of 5%, back when only children could receive reimbursed Medicaid care, the percentage is often lower than traditional insurances’.
At times, the provider list is inaccurate—noting dentists who no longer accept Medicaid insurance and dentists who are too booked to welcome new patients, regardless of their insurance type. Edmonds warns, too, that Virginia has a shortage of dental assistants, making it challenging for some dentists to keep up with patient demand. The demand could spike higher: The name of one of the state’s dental Medicaid programs is Smiles for Children and, although it was originally used for both children and adults, it confused some into thinking adults weren’t covered. A new name—Cardinal Care—for adult services was introduced in 2023. Less confusion over the name may cause more people to sign up and more demand for services.
Considering roadblocks for dental patients with Medicaid, and all insurances, Edmonds knows how important it is for his practice to be well-staffed and well-known.
“We’re looking at hiring two more practitioners,” he says. “Word of mouth and customer service are really starting to impact [the demand for] our practice.”
Learn more at restoredentalhr.com.
Kristen De Deyn Kirk
