. . . “They're going 'My mouth hurts, I can't chew, I can't do this.' And then we expect them to focus and do well in school and their mouth is just on fire,” she said.

But Sundve, who lives in Litchfield, Minn., said getting her foster kids in to see a dentist was hard. It's because they're on Medical Assistance — or Medicaid, as it's more commonly known outside Minnesota — and don’t see a dentist regularly.

You call and call and call and ask people if they have any new patients’ availability. And the answer often is ‘No.’"

. . . In 2021, state legislators tried to fix the problem by nearly doubling the amount of money MA pays dentists for each appointment. They set goals for the number of visits MA enrollees should have annually.

But based on data from the state and from health insurance companies that manage most MA enrollees, the changes haven’t made much of a difference.

For years, low reimbursement rates were to blame for Minnesota’s notably low access to dental care for MA enrollees, Liebling said. Rates were based on decades old dental costs.

“Kind of famously, those rates are really low. Another complaint we would hear is that dentists weren't even told what they would be paid until after they provided the service,” she said.

Low-income Minnesota families struggle to get dental care, MPR 11/28/18

About 655,000 Minnesota children were enrolled in Medicaid, but only 36 percent of them received dental services included in their coverage, according to 2017 statistics. That puts Minnesota noticeably below the national average.

The number of dentists who see children in public programs declined from 2,906 in 2015 to about 2,253 last year, according to the Department of Human Services.