Hundreds of thousands of Coloradans will have new dental care benefits in 2014 under twin health-reform efforts, but state leaders now must scramble to find providers who will care for them.

A new dental benefit for adults with Medicaid, coupled with an Obamacare expansion of eligibility and pediatric benefits required on the state exchange, will balloon the number of paying patients.

But many Colorado dentists say the new patients still won’t come with enough revenue to be worth the headaches of care and bureaucracy.

Other patients simply have no nearby dentist to try — nine Colorado counties had no dentist at all in the last survey.

About 335,000 current Medicaid adults gain access to dental care in the spring, and tens of thousands more will join Medicaid rolls under the Affordable Care Act expansion. Added to them will be potentially thousands of privately insured children with dental care included under “essential benefits” minimums of the state health exchange.

Even if only 20 to 25 percent of those eligible start taking advantage of dental benefits, “that’s 95,000 people seeking care,” said Karen Cody Carlson, executive director of the nonprofit Oral Health Colorado. “Having the benefit is a great positive step, but it’s creating an access problem as well,” she said.

Colorado has about 3,600 dentists, according to statewide surveys and licensure records. Of those, about 1,000 are actively enrolled as Medicaid providers, Carlson said. And of that 1,000, only about 690 take enough Medicaid patients to bill more than $10,000 in claims in a year, a threshold for assessing participation.

After striving for years to get an adult benefit included in Medicaid — the program already offers children benefits through CHP Plus — dentists and public health officials have now launched a campaign to convince colleagues to take on more public patients.

Through publicity, training and personal persuasion, the Colorado Dental Association is beginning a “Take Five” effort to get each dentist in the state to accept at least five Medicaid patients or families in the coming year.

The advocates are also working behind the scenes with Medicaid officials to streamline the signup and payment bureaucracy that earned an abysmal reputation among many Colorado dentists in past years.

Lakewood’s Dr. Jeff Hurst will be a prime target of the persuaders. He is open-minded to rejoining Medicaid and helped push for the changes, but he has been out of the program for decades because of infinitesimal reimbursement and maddening paperwork.

“It’s very daunting for a lot of dentists to see a packet of 40 pages to fill out (when trying to join Medicaid),” said Dr. Carol Morrow, a Walsh dentist working on state committees and with southeastern Colorado colleagues to expand public care. Medicaid has pledged to work with the dental community to speed signups and reimbursement, while also raising payment rates per procedure.

“If the state really goes through with all these, I will throw my name back into the ring again,” Hurst said. “Many dentists in Colorado would like to see more patients, if these barriers are truly taken down.”

Legislation passed earlier this year sets a Medicaid adult benefit by at least April. It will be paid for by millions from the state’s unclaimed-property fund, matched by federal dollars available for certain optional expansions of Medicaid benefits.

In the first full fiscal year of the new benefit, from July 2014 to June 2015, the program will cost the state about $23 million and the federal government about $65 million, the legislation says.

The state share accounts for about $4 million in savings from fewer emergency dental services, which are the only adult benefits currently covered and which will decline if adults get better preventive and maintenance care.

Advocates for the benefit have argued for years that an increasing pile of research shows direct connections between better oral care and overall medical health. Many of the Medicaid adults haven’t seen dentists for years, and abscesses, infections and disease lead to crisis. Mouth bacteria have even been shown as factors in heart disease, stroke and maternal health.

Surveys consistently show that more than 30 percent of Colorado adults haven’t seen a dentist in the past year, and 20 to 25 percent of children have high levels of decay-inducing bacteria.

“I can track in my small area how many people go to the emergency rooms and how much that costs — it’s insane,” said Morrow, whose practice treats people from Colorado, southwestern Kansas and the Oklahoma Panhandle. “It will save my own county hundreds of thousands of dollars.”

Morrow and Hurst said reimbursement has crept up 4 percent this year and will go up 2 to 3 percent again next year, bringing Medicaid patients closer to a break-even or slightly profitable proposition.

Morrow said she tells fellow dentists that what’s even more important is that the new benefits allow them to practice health care the way it should be. The model moves from emergencies and extractions only, to preserving teeth, saving teeth, creating dentures and other wholesome changes.

“They will have preventive care, which they may never have had in their whole life,” Morrow said.

Michael Booth: 303-954-1686, mbooth@denverpost.com or twitter.com/mboothdp