On July 1 more than 26,000 undocumented people in Contra Costa County will lose access to publicly funded dental insurance, a county official told Richmondside.
“We’re in for a rough road here,” said Dr. Ariane Terlet, chief dental officer at La Clinica de la Raza, which has a clinic in Pittsburg. “All of the clinics are expecting the worst.”
Terlet has been at La Clinica for 37 years. It’s a major care provider for patients with public dental insurance in Alameda, Contra Costa and Solano counties. La Clinica also offers cash pay options.
Terlet worries that without dental insurance people will delay exams and preventative procedures with potentially disastrous complications.
“You can die from a dental infection,” if it isn’t treated properly, Terlet said.
Dental insurance cuts are trickle-down impact of Trump’s ‘One Big Beautiful Bill’
Dental care options
Are you losing your dental insurance? Here are some places where you might find low-cost care:
- Lifelong Medical Care, William Jenkins Dental Care, 150 Harbour Way, Richmond
- Contra Costa Health, West County Dental Clinic, 13601 San Pablo Ave., San Pablo
- La Clinica de la Raza, Pittsburg Dental, 339 E. Leland Road, Pittsburg
For more information, visit the state’s Medi-Cal dental benefit changes resource page or the Contra Costa Dental Society.
The dental insurance cuts are the result of changes in both federal and state policies.
Nationally, states are implementing changes required by Trump’s One Big Beautiful Bill Act (OBBBA), which will slash a projected $911 billion from Medicaid over the next decade.
Medicaid is a federal-state partnership designed to provide low-income Americans with health insurance. In California, this program is called Medi-Cal. Medi-Cal also provides dental benefits, called Medi-Cal Dental.
As the federal government reduces funding for Medi-Cal, California is scrambling to make up the difference. Gov. Gavin Newsom, to cope with a $2.9 billion deficit in the upcoming fiscal year, proposed large cuts to Medi-Cal and other programs to balance the budget.
In 2025, 324,915 people were enrolled in Medi-Cal Dental in Contra Costa County. About 8% of them will no longer be able to access their benefits for routine dental care starting July 1, when a state policy retracting Medi-Cal Dental from undocumented immigrants goes into effect.
Emergency services, such as treatment for broken teeth, gum infections, and swelling may still be covered. And pregnant women, postpartum women up to one year after pregnancy and children under age 19 will still be eligible for dental benefits.
The potentially dangerous impacts of going without dental care
About 95% of Dr. Parwin Shiran Singh’s patients receive Medi-Cal Dental benefits.
Singh is a dentist and the Associate Dental Director at the Brookside San Pablo Health Center for Lifelong Medical Care. From May 2025 to April 2026, Lifelong saw 26,500 patient visits at its Alameda and Contra Costa County sites.
Singh told Richmondside that she and her organization as a whole have been preparing for this loss of coverage.
She said that many of her patients have received notices from the state Department of Health Care Services that their coverage will be terminated on July 1.
While she and Lifelong have been trying to help patients get care before that date, she is worried that patients will delay dental care after they lose their insurance.
“I’m worried that they will stop coming in for their regular checkups and cleanings and wait until something hurts to come,” Singh said. “And by the time something hurts, the treatment is more complicated, more expensive, and, ultimately most likely will end up in extraction.”
Uninsured patients can still be seen at Lifelong, but they will be responsible for paying for services on a sliding scale based on family size and income. Singh expects that “some of [her patients] will come back as cash patients, and some of them won’t. It depends on what their life situation is, “ she said.
When people have a lot of responsibilities, she said, they tend to put themselves last and that, unfortunately, includes preventative dental care.
Singh and Terlet both emphasized the role that dental care plays in one’s overall health. If a patient has dental pain, they are unlikely to eat a fibrous and healthy diet. The inflammation from infected teeth can itself cause problems for people with diabetes. Dental infections can allow bacteria to enter the bloodstream, which can lead to dangerous facial infections that cause swelling and even heart disease.
What if the only treatment for a broken arm was amputation?
Under new regulations, Medi-Cal will cover emergency dental care in cases where a tooth must be extracted.
Terlet said that such regulations will hamstring dentists from providing restorative care. She compared it to treating a broken arm with an amputation.
“ It’s the equivalent of you came in to the emergency room … with a broken arm. And so the only thing I can offer you is an amputation,” she said. “Because setting the arm in a cast or doing surgery is not an option.”
“Otherwise, you go to the emergency room and you get an antibiotic and a prescription for pain medication. And the problem doesn’t go away. It just gets you out of pain,” she said.
She said that this approach may lead to more antibiotics and opiates being prescribed while not addressing the underlying dental issue.
“This isn’t our first rodeo,” Terlet said. She was referring to July 2009, when California eliminated Medi-Cal Dental comprehensive adult dental coverage due to state budget constraints. This change left more than three million Californians without dental insurance through Medi-Cal.
Researcher Astha Singhal and her team found that the 2009 change led to a 32.3% monthly increase in dental care emergency room visits for adults enrolled in Medi-Cal. Over a year, this equaled more than 1,800 additional emergency visits for Medi-Cal members.
These visits also may have been more expensive, given that the costs of dental emergency visits increased by 68% during that timeframe. These visits were covered by Medi-Cal, further burdening an already constrained budget.
Importantly, young adults, racial minority groups and urban residents were disproportionately impacted by this change.
Alternatives to using Medi-Cal Dental benefits
Dr. Raynato “Ray” Castro, a private practice dentist in San Pablo, is also worried about Contra Costa County residents losing dental insurance and not maintaining their regular exams.
Castro has lived in west Contra Costa County for most of his life. He was the past president of the Contra Costa County Dental Society.
Castro’s office does not accept Medi-Cal Dental insurance, due to reimbursement rates being 50% less than private insurance. He still has a number of patients on Medi-Cal Dental who pay out of pocket.
“I do see a lot of folks who are maybe recent immigrants or cash-basis only,” Castro said. He said he doesn’t expect his patient volume to drop significantly, because dental treatment is “something that you can still pay cash for,” as opposed to general medical care, where a bill for a major procedure could be $100,000.
“A cleaning might be $150 to $300 a visit,” he said.. “Which is not the cheapest thing in the world, but it’s something essential.”
Castro said he expects patients who lose dental insurance will either pay cash or start using emergency options, such as free clinics or “suitcase clinics” like mobile health vans. “But is that really the answer?” he asked.
Terlet worries about something more nefarious.
“I honestly believe that we’re going to see increased illegal practice or unlicensed practice of dentistry,” she said. “I’ve seen it in my career. When the economy wasn’t good, people did things that they shouldn’t have done.”
“I honestly believe that we’re going to see increased illegal practice or unlicensed practice of dentistry.”
— Dr. Ariane Terlet, chief dental officer at La Clinica de la Raza
Photo courtesy of Ariane Terlet
With the Berkeley Free Clinic’s dental care on hiatus, there are not many truly free clinics in the county. However, Castro said that the Contra Costa Dental Society had a charitable arm “that helps raise money and provide care for people who slip between the cracks of what [Medi-Cal Dental] might not cover.”
Terlet succinctly summarized her prediction for uninsured patients. “All roads lead to the hospital,” she said.
Castro echoed a similar sentiment.
“My anxiety is that the whole system’s going to get strained, and people are going to slip through the cracks.”
