While millions of Californians qualify for free dental and vision care through Medi-Cal, only a fraction use these benefits — a gap that reveals deep inequities in access, awareness, and trust within the state’s healthcare system.
In a briefing titled “Too Many Californians Are Missing Out on Free Medi-Cal Dental and Vision Care — Let’s Change That”, held by American Community Media, three leading voices from the California Department of Health Care Services (DHCS) and advocacy group Children Now examined why so many residents fail to access essential preventive services, and what can be done to change that.
The panel featured Donny Shiu, Vision Program Chief at DHCS; Dana Durham, Dental Division Chief at DHCS; and Eileen Espejo, Senior Managing Director of Health at Children Now. Together, they offered a comprehensive view of how dental and vision care intersect with CalAIM’s mission: creating a person-centered, equitable healthcare system that keeps communities healthy — before illness strikes.
Prevention, Equity, and the Power of Information
Durham opened with a stark fact: “Only one in five adults on Medi-Cal uses their dental benefits each year.” For her, this underuse is not about indifference but about information gaps, fear, and structural barriers.
“Many Californians don’t know that they qualify for free cleanings, checkups, or eye exams,” she explained. “If you have Medi-Cal, you never have to pay for dental care. Ever.”
That message, simple yet powerful, underscored a broader challenge. Even when coverage exists, misinformation and logistical barriers — from language to appointment coordination — keep patients away. To counter this, DHCS has expanded its tools, including the multilingual “Find a Dentist” app and the Smile California hotline, which helps patients schedule appointments and navigate coverage.
“We’re working to make it easier for dentists to enroll as Medi-Cal providers,” Durham added. “For years, bureaucracy discouraged participation. Now, the system is simpler — and the goal is clear: more providers, more access, more care.”
Durham also addressed a recurring misconception — that dental care is somehow separate from overall health. “Bleeding gums can signal diabetes. Poor oral health can worsen heart disease,” she warned. “Integrating dental care into general health is essential. Oral health is overall health.”
For Donny Shiu, vision services are a critical but often overlooked part of public health. “We want every Medi-Cal member to know that vision care is included — exams, glasses, follow-ups. It’s all part of keeping families healthy and thriving,” he said.
Shiu connected this effort to CalAIM, a statewide initiative transforming how Medi-Cal operates. “Historically, the system was fragmented and reactive,” he noted. “CalAIM is about seeing the person as a whole — not just treating illness, but preventing it. It’s a complete shift toward proactive, integrated care.”
That holistic approach also extends to community partnerships. Shiu emphasized the importance of collaboration with schools, clinics, and local health workers to reach families who may face linguistic or geographic barriers. “Equity starts with access,” he said. “And access starts with trust.”
Children, Schools, and the Hidden Cost of Neglect
In the second half of the briefing, Eileen Espejo turned the spotlight to California’s children — a group whose oral and vision health directly affects their learning, well-being, and social development.
“When a child has a cavity, it’s not just about pain,” she said. “They might struggle to sleep, eat, or even speak clearly. They might miss school. Studies show that poor oral health is linked to chronic absenteeism — and that means lower academic performance.”
Espejo cited evidence showing that oral infections among children can lead to cascading effects: missed classes, lost work hours for parents, and declining confidence among students. “If a child feels embarrassed about their teeth, they might stop smiling or socializing. It becomes a mental health issue too,” she explained.
Her organization, Children Now, has been working to close these gaps through school-based programs and legislative advocacy. By integrating dental and vision screenings into school health systems, Espejo believes children can receive preventive care early — before problems become emergencies.
And, crucially, all children in California are eligible for Medi-Cal coverage, regardless of immigration status. “Every child under 19 qualifies for dental and vision services,” she emphasized. “That’s the law. But too many parents don’t know it.”
Language, Culture, and the Fear Factor
Throughout the discussion, panelists agreed that fear — not cost — remains one of the biggest barriers. For immigrants and low-income communities, distrust of institutions, language barriers, and lack of culturally competent care often prevent access.
“Some families don’t go to the dentist because they think they’ll be billed later,” Durham explained. “Others can’t find a provider who speaks their language or offers appointments outside work hours.”
Shiu and Espejo both stressed the importance of culturally tailored communication. “Parents trust their pediatricians,” Espejo noted. “So we’re training doctors to talk to families about oral and vision care. The message is simple: preventive care is safe, free, and vital.”
To reinforce this message at home, Children Now promotes tools like the “Brush, Book, Bed” initiative, which encourages parents to brush their children’s teeth, read a bedtime story, and create nightly routines that strengthen both oral hygiene and family bonds.
“Prevention starts at home,” Espejo said. “Even wiping a baby’s gums before teeth appear helps. It’s about education, not fear.”
The panel closed with a call to action — for journalists, community leaders, and healthcare advocates alike. “Talk about these programs,” urged Durham. “If you know someone who qualifies for Medi-Cal, tell them their benefits are free. Tell them where to find care. Awareness saves lives.”
Shiu echoed that sentiment: “Dental and vision care are not luxuries. They are fundamental to human dignity. Every checkup, every pair of glasses, every cleaning — they all build healthier communities.”