Independent watchdog project. Not affiliated with the State of California, DHCS or Medi-Cal Dental.

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I can't smile, California

Not the State of California

Dental Awards

Welcome to the first annual i can't smile, CALIFORNIA Dental Awards, honoring the Medi-Cal dental plans that do a truly remarkable amount with a truly remarkable number of specialists.

Programming note

The Los Angeles County ceremony has been postponed until further notice. Tonight's awards cover Sacramento County only, home of the State Capitol and the county where Medi-Cal members must join one of three dental plans, with few exceptions. In Los Angeles County, joining is optional. Los Angeles nominees are asked to keep their acceptance speeches on file.

Tonight's category

Prosthodontics

Before the envelope, a short lesson: what a prosthodontist is, why it matters, and how to read a directory listing. Then the show. Click, tap, swipe or use the arrow keys, with the sound on or off.

Skip the slideshow

    Prosthodontics 101

    First, a short lesson.

    Nobody hands out an award in a specialty most people have never heard of without explaining it first. Seven quick slides, then the ceremony. Press Next when you are ready, or use the arrow keys.

    prostho = replacement

    What is a prosthodontist?

    The replacement specialist.

    Prostho means replacement. Dontist means teeth. A prosthodontist is a dentist who specializes in replacing what is missing, whether that is one tooth, several, or all of them. The American Dental Association recognizes prosthodontics as a dental specialty and defines it as the one for “patients with clinical conditions associated with missing or deficient teeth.”

    ADA National Commission, Recognized Dental Specialties; American College of Prosthodontists.

    Why they exist

    Missing teeth are not a cosmetic problem.

    Teeth hold up the face, chew the food and shape the words. Lose enough of them and eating, speaking and working all change. Medi-Cal knows it: full and partial dentures, denture relines and crowns are covered benefits for adults. Covered on paper is the start. Someone still has to make them fit.

    Smile, California, covered services for adults.

    General dentist Prosthodontist 4 years 4 years + 3 more +3

    General dentist or prosthodontist?

    Both may make a partial. One trained three more years to.

    In California, constructing, altering or repairing a bridge, crown or denture is part of the legal definition of dentistry, so any licensed dentist may do it. A prosthodontist finished dental school and then spent at least three more years in an accredited residency devoted to exactly that: implants, crowns, bridges, complete and partial dentures, the bite and the appearance. Rebuilding a face after cancer, an injury or a birth defect, called maxillofacial prosthetics, takes one more year on top.

    Business and Professions Code 1625(c); American College of Prosthodontists, position statement; ADA News, January 2025.

    clasp your teeth metal bar new teeth

    Partials, in particular

    A partial is a small machine that lives in your mouth.

    A removable partial denture is a frame carrying replacement teeth that clips to the teeth you still have. It rests on gum and bone and it moves every time you chew. Design, materials, bite and fit are the whole game. Done well, you forget it is there. Done badly, it rubs sores, strains the teeth it clips to, and ends up in a drawer. That design work is what a prosthodontic residency spends three years on.

    American College of Prosthodontists, Why see a prosthodontist.

    Three labels that are not the same

    Certified. Eligible. Qualified.

    The ADA's specialty commission draws the lines:

    • Educationally qualified: finished dental school and an accredited residency, and holds a license.
    • Board eligible: did all of that and is prepared to sit the specialty board's exam.
    • Board certified: passed it.

    For prosthodontics the board is the American Board of Prosthodontics. Its exam runs in sections: a written test, patient treatment presentations, a scenario-based oral exam and an implant case. Those who pass are called Diplomates. Certification is voluntary, and plenty of fine prosthodontists are not certified. Every one of them, though, did the residency.

    ADA National Commission, Recognized Certifying Boards; American Board of Prosthodontics.

    prosthodontist near Sacramento Dr Example, DDS 2.9 miles away Specialty: General Dentist, Prosthodontics Board certification: ? Federal registry: General Practice

    How to read a directory

    The listing tells on itself.

    Look at the specialty field first. “Prosthodontics” on its own means the plan is presenting that dentist as a specialist. “General Dentist, Prosthodontics” means the plan is telling you something else first. Look at the board certification field, and notice when it is blank. Then check the federal provider registry, which is public, free, and shows the specialty each dentist declared. It takes about a minute.

    NPI Registry, the federal National Plan and Provider Enumeration System.

    That is the lesson

    Prepare for the awards.

    You now know more about prosthodontics than most people who build dental plan directories. Take your seat. The house lights are going down.

    Live from the county of the State Capitol

    The i can't smile, CALIFORNIA Dental Awards

    Category two: Prosthodontics. Sacramento County, where 551,922 Medi-Cal members are required to belong to one of three dental plans, and where every one of those plans is on the State's list of plans that must contract with prosthodontists.

    DHCS DMC Methodology Overview; DHCS 2021 network adequacy certification; enrollment, August 2026.

    Tonight's nominees

    Three plans. One question.

    1. Liberty Dental Plan 290,306 Sacramento County members
    2. Health Net 192,121 members
    3. California Dental Network (DentaQuest) 69,495 members

    Judged the only way we know how: by what each plan's own directory said on 14 September 2026 when we searched for a prosthodontist near Sacramento.

    The envelope, please

    And the winner is…

    A drumroll, if your sound is on. Press Open it when you cannot stand it any longer.

    2 1 3 chirp chirp

    The winner

    Nobody.

    No gold. No silver. No bronze.

    Three plans. Three directories. Zero verified prosthodontists. The gold step is being held by the only thing we could find that everyone agreed was there.

    What each directory actually said

    No winners this time, folks.

    • Health NetProsthodontist is not a choice in its specialty menu. The nearest thing, “Dental Prosthetics,” returned 11 dentists near Sacramento: 10 endodontists, who do root canals, and 1 periodontist. Prosthodontists: 0
    • California Dental Network (DentaQuest)Its search filter for the Sacramento adult plan has no prosthodontics option. The directory file it publishes for download, dated 1 July 2026, has 2,556 listings in Sacramento-area ZIP codes, and not one is a prosthodontist. Prosthodontists: 0
    • Liberty Dental Plan8 listings for a prosthodontist within 50 miles of Sacramento. Three names, every one labeled “General Dentist, Prosthodontics,” board certification blank. The federal registry lists the dentist at six of those eight offices as a general dentist. Verified prosthodontists: 0
    What this means for you

    The scoreboard

    Tonight's numbers, straight from the plans

    Three Sacramento directories, searched for a prosthodontist on 14 September 2026, and checked against the federal provider registry the way the lesson describes.

    0

    Verified prosthodontists across all three Sacramento directories

    551,922

    Sacramento County members who must belong to one of the three plans

    10

    Endodontists Health Net offered when asked for dental prosthetics

    3

    Names in Liberty's prosthodontist results, each labeled General Dentist first

    2,556

    Sacramento-area listings in the California Dental Network (DentaQuest) directory file, none of them a prosthodontist

    30

    Business days a plan has to get an adult member a specialist appointment once the referral is authorized

    The prosthodontist searches behind tonight's result, 14 September 2026
    Plan Where and how we searched What came back
    Health Net Health Net Medi-Cal dental, adult directory, dentists by specialty, near Sacramento, CA. Prosthodontics is not offered as a specialty, so we chose the closest option, Dental Prosthetics. 11 dentists: 10 listed as endodontics and 1 as periodontics. Prosthodontists: none.
    California Dental Network (DentaQuest) DentaQuest Find a Dentist, Medi-Cal DMC adult plan, within 50 miles of ZIP 95819, looking for a prosthodontics specialty filter. Then its downloadable directory file for the California Medi-Cal DMC adult plan, counted by ZIP code and specialty. The specialty filter for that plan and area offers nine choices: dental anesthesiology, dental hygienist, denturist, endodontics, general dentistry, oral and maxillofacial surgery, orthodontics, pediatric dentistry and periodontics. Prosthodontics is not one of them. The downloadable file, dated 1 July 2026, has 2,556 listings in ZIP codes beginning 956, 957 or 958, and none is a prosthodontist. All 71 prosthodontist listings in the file are in Southern California. Prosthodontists: none.
    Liberty Dental Plan Liberty Medi-Cal dentist search, Medi-Cal GMC/PHP network, specialty prosthodontist, under 50 miles of Sacramento. 8 listings, 3 names: one dentist at 6 offices, two more at 1 office each, the farthest in Stockton. Every listing says “General Dentist, Prosthodontics” and leaves the board certification field blank. The federal registry lists the dentist at the 6 offices as a general dentist; the other two names, as the directory spells them, returned no dentist in the registry. Verified prosthodontists: none.

    Where this comes from, and who answers for it. Every count above comes from the plans' own public provider directories, which state law and federal Medicaid rules require them to publish (HSC 1367.27; 42 CFR 438.10(h)), checked against the public NPI Registry. The plans publish these directories and answer for what is in them. We are not suggesting any dentist listed has done anything wrong; a general dentist may lawfully make dentures, and the label is the plan's. If you are one of those dentists and your listing is wrong, tell us and we will report it to the plan. Directories change weekly, so run the searches yourself and send us anything different.

    The part where we get real

    No winners this time, folks.

    The rest of this site is polished. This part is not. It is written for the people this actually happens to, and it says what we actually think. Where we state a rule, we quote it. Where we cannot prove something yet, we say so.

    We are sorry to inform you

    If you are a low-income resident of Sacramento County, you were placed in a Medi-Cal dental plan you did not pick, run by companies owned by insurance giants and a private equity firm, and as of tonight none of the three lists a verified prosthodontist. If you ever need one, the honest odds are that you will not see one through your plan. Not without a fight.

    Even if your dentist refers you

    A referral to a specialist the plan does not have puts the plan in an awkward spot, because the rules say it must send you outside its network and pay for it. That is the moment things tend to get strange. The plan may not want to sign a one-time agreement with an outside prosthodontist. It may point you to a community clinic that has no prosthodontist either, then to another. The referral may never make it into the system. You may be treated like a case number and told, warmly, that nothing went wrong. You may have to fight harder for a set of teeth than you have fought for anything in your life.

    Why running straight to the State may not be your best first move

    Here is the part almost nobody tells you. Complaining to the State is your right, and we show you how elsewhere on this site. But the State does not book your appointment. The plan does. The rule that gets you into a chair is this one, from the contract every Medi-Cal dental plan signs with DHCS:

    DHCS Dental Managed Care contract, 2025, Exhibit A8, section 9

    “If Contractor's provider network is unable to provide necessary services, covered under the contract, to a particular Member, Contractor must adequately and timely cover these services out-of-network for the Member, for as long as Contractor's provider network is unable to provide them.”

    The next line says the plan must make sure the cost to you is “no greater than it would be if the services were furnished within the network.” The same words sit in federal Medicaid rules, 42 CFR 438.206(b)(4) and (5).

    The contract even spells out the mechanics. Where the State has excused a plan from its distance standard for a type of specialist, the plan must help you get an appointment with an out-of-network specialist and “make its best effort to establish a Member-specific case agreement with an Out-Of-Network core Specialist at the Medi-Cal Fee-For-Service rate or a mutually agreed upon rate.” That outside specialist must be able to see you within the same time and distance standards, or the plan must arrange your ride. And once a specialist referral is authorized, an adult member must be offered the appointment within 30 business days.

    In plain words: no prosthodontist in the network is the plan's problem to solve, on the plan's clock, at the plan's expense. The State pays each plan a flat amount per member per month whether you get care or not, so every outside referral comes out of that. Draw your own conclusions about the incentive.

    DHCS DMC boilerplate contract, 2025: Exhibit A8, sections 5 and 9; Exhibit A11, sections 1, 3.2, 3.4 and 10. How the plans are paid.

    Watch for these moves

    Patterns to watch for, described in general terms. They are warnings, not findings about any one plan or person.

    The referral that never got logged

    Your dentist says it was sent. The plan says it has nothing. Nothing is authorized, nothing is denied, and the clock never starts.

    The clinic hop

    You are sent to a community clinic that has no prosthodontist, then to another that does not have one either. Round and round.

    The ticket to nowhere

    A friendly voice opens a ticket. Nobody calls back. Call again and the ticket cannot be found.

    Your dentist is your best ally. Sometimes your only one.

    Some general dentists know exactly what these plans are like. They know you cannot afford to go anywhere else and they know nobody else is coming, so they treat you themselves, as well as they can. Be grateful for those. Others may see something different: three things that could be done in one visit, spread across three visits weeks apart, because every visit bills. If your treatment plan looks like a calendar with no end, ask why.

    If you were referred to a prosthodontist while in one of these plans, ask your dentist to help you fight. Ask them to put the referral in writing, into the plan's own system, and to send a copy to the plan's dental director, the one person California law makes answerable for dental decisions being made by qualified people. Keep copies of everything. If nothing comes back in writing, here is what to do.

    Dentists of Sacramento, this part is for you

    You know these networks better than your patients ever will. When a patient needs a specialist the plan does not have, put the referral in writing, demand the authorization, and keep demanding it. If a plan answers with pressure, a threat to hold payments, to end your contract, anything, write that down too. The Department of Managed Health Care and DHCS both take documentation from providers, and a dentist's paper trail is much harder to wave away than a patient's word. Enough of those trails, side by side, is what a real enforcement case is built from.

    Being straight with you

    • We believe, but cannot yet prove, that Sacramento members have gone a long time without real access to a prosthodontist, referral or no referral. We are looking for the records that would settle it: referral logs, authorization data and the State's network reviews.
    • We do not know how many out-of-network case agreements any of the three plans has signed for prosthodontics, or whether the State has ever asked.
    • Whether the State has excused any of the three plans from its access standards for prosthodontics, what the contract calls an alternate access standard, we have not found published.
    • The fines we have found are in our library. Whether fines that size change anything, judge for yourself.

    Don't hold your breath. Hold the line.

    The answers will come. Keep the trail. Stay the course. Be patient with everyone except the deadline.

    Before you act on anything here, talk to a professional advisor, the Health Consumer Alliance, or the State departments. This is what we think and how we would fight. It is not legal advice.

    Earlier this season

    Category one: a podium, three special awards, and two periodontists for 551,922 members.

    Show your work

    Sources

    Everything stated as fact on this page traces to one of these. If you find an error, tell us and we will correct it.

    1. Health Net, California Dental Network (DentaQuest) and Liberty Dental Plan, Medi-Cal provider directories for the Sacramento area, prosthodontics, searched 14 September 2026. Search settings are listed in the scoreboard.
    2. California Dental Network (DentaQuest), downloadable provider directory files, which it calls machine-readable directories. California Medi-Cal DMC adult file, every row dated 1 July 2026, counted by ZIP code and primary specialty.
    3. Centers for Medicare and Medicaid Services, NPI Registry, the National Plan and Provider Enumeration System. Used to check the specialty declared by dentists the directories list as prosthodontists.
    4. American Dental Association, National Commission on Recognition of Dental Specialties and Certifying Boards, Recognized Certifying Boards. Definitions of board certified, board eligible and educationally qualified; the American Board of Prosthodontics as the certifying board for prosthodontics.
    5. American Board of Prosthodontics, Importance of Board Certification and Examination Guidelines. Sections A to D of the certifying examination; Diplomates.
    6. American College of Prosthodontists, position statement on what a prosthodontist is, and Why see a prosthodontist. Three years of residency after dental school, one more for maxillofacial prosthetics, and what prosthodontists treat.
    7. ADA News, Five things to know about the American College of Prosthodontists, January 2025.
    8. California Business and Professions Code 1625. The practice of dentistry includes constructing, altering, repairing or selling a bridge, crown, denture or other prosthetic appliance.
    9. Smile, California, covered services for adults. Partial and full dentures, denture relines and crowns as Medi-Cal dental benefits.
    10. DHCS, Dental Managed Care boilerplate contract, 2025. Exhibit A8, sections 5 (specialists) and 9 (out-of-network coverage when the network cannot provide a service); Exhibit A11, sections 1 (out-of-network case agreements under an alternate access standard), 3.2 (specialist appointments within 30 business days), 3.4 (provider shortage) and 10 (out-of-network providers).
    11. Code of Federal Regulations, title 42, section 438.206(b)(4) and (5). Out-of-network coverage when a Medicaid managed care network cannot provide a covered service, at no greater cost to the member.
    12. Health Net, California Dental Network (DentaQuest) and Liberty Dental Plan, Medi-Cal provider directories for the Sacramento area, periodontics, searched 14 September 2026. Search settings are listed in the Periodontics awards.
    13. California Department of Health Care Services, Medi-Cal Dental Managed Care (DMC) Methodology Overview, 29 August 2025. Required provider types, ratio and distance standards, secret shopper surveys, directory language reporting.
    14. California Department of Health Care Services, Dental Managed Care Network Adequacy Certification, September 2021. Definition of each plan's specialist network.
    15. California Department of Health Care Services, Medi-Cal Dental Managed Care. The two counties where dental managed care operates, mandatory enrollment in Sacramento County and opt-in enrollment in Los Angeles County.
    16. American Dental Association, National Commission on Recognition of Dental Specialties and Certifying Boards, Recognized Dental Specialties. Definitions of periodontics and prosthodontics.
    17. California Health and Safety Code 1367.27. Provider directory publication, weekly updates and inaccuracy reporting.
    18. California Code of Regulations, title 28, section 1300.67.2.2. Timely access standards for dental plans.
    19. Code of Federal Regulations, title 42, section 438.10(h). Medicaid managed care provider directory contents.
    20. California Dental Network (DentaQuest), Sacramento County Community Advisory Committee minutes, 12 March 2026. Sacramento County member base, dental visit and preventive care rates.
    21. California Health and Human Services Open Data Portal, Medi-Cal Managed Care Enrollment Report, August 2026 count. Enrollment by dental plan in Sacramento County, filtered to the three rows used on this page.
    22. Centers for Disease Control and Prevention, About Periodontal (Gum) Disease, reviewed 15 May 2024. Prevalence of periodontitis, risk groups, tooth loss, referral to a periodontist.
    23. Eke PI and others, Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009 to 2014, Journal of the American Dental Association, 2018. 42% of adults 30 or older with periodontitis, 7.8% severe, 60% among adults below the poverty level.
    24. American Academy of Periodontology, What is a Periodontist? Training and referral from general dentists.

    Tried to see a prosthodontist? Or a periodontist?

    If you were referred to a specialist your plan could not provide, or a directory sent you to an office that could not see you, we want to hear about it.

    Tell us what happened