Comprehensive Dental and Oral Surgery Information
A Veteran eligible for comprehensive dental care will normally start his/her therapy with a comprehensive examination, including all appropriate x-rays, to determine an overall treatment plan.
Dental benefits are provided by the Department of Veterans Affairs according to law. In some instances, VA is authorized to provide comprehensive dental care, while in other cases treatment may be limited. Specific dental eligibility guidelines are outlined in VHA Handbook 1130.01. As these guidelines are complex, Veterans with eligibility questions are encouraged to contact the facility’s Department of Enrollment and Eligibility and/or visit the following website:
The extent to which dental services may be rendered is strictly based upon a Veteran’s dental eligibility status. As defined by VHA Handbook 113.01, the scope of outpatient dental care falls into one of three broad categories:
- Comprehensive – This includes treatment that is reasonably necessary and clinically determined by the treating dentist to meet the Veteran’s dental needs. The goal of comprehensive care is to attain and sustain oral health and function.
- Focused – This includes treatment to resolve a specific dental condition dependent upon, and consistent with, the Veteran’s eligibility classification. The goal of care is to provide a specific improvement of oral conditions that directly impact the medical condition, assist in vocational rehabilitation, or to provide dental care professionally determined to be medically and functionally appropriate to their status for those in a VA Community Living Center or extended care facility.
- Emergency – This care may be provided as a humanitarian service to Veterans who do not have established dental eligibility. Dental treatment is limited to that necessary to address a dental condition that is determined to be endangering life.
A Veteran eligible for comprehensive dental care will normally start his/her therapy with a comprehensive examination, including all appropriate x-rays, to determine an overall treatment plan. This plan may be executed in sequential phases, as detailed below:
Emergency Phase – addresses urgent issues like pain and infection
Control Phase – addresses active disease states, such as tooth decay (dental caries) and/or gum disease (periodontitis)
Definitive Phase – addresses issues more elective in nature, such as the replacement of missing teeth
Multiple appointments will usually be required to complete most treatment plans. Our staff will work with you to establish appointment times mutually convenient for your schedule and the clinic’s availability. Some planned treatments may require referral to an outside specialist, (e.g., oral surgeon, endodontist, periodontist, etc.): in such cases, the facility’s Department of Community Care will coordinate appointments outside our clinic.
Our clinic provides a wide variety of services, including, but not limited to, each of the following disciplines:
Maintenance Care – routine cleanings and periodic examinations, (i.e., check-ups)
Non-Surgical Periodontics – removing long-standing tartar (calculus) from the roots of teeth via scaling and root planing (“deep cleaning”)
Oral Pathology – screening and follow-up of abnormal soft and hard tissue findings
Oral Surgery – removal of hopeless teeth
Endodontics – root canal therapy on infected teeth with a good restorative prognosis
Restorative Therapy – addressing decayed and/or broken teeth with fillings (direct restorations), or when appropriate with crowns (indirect restorations)
Fixed Prosthodontics – replacement of missing teeth with fixed bridges and/or implants – see separate paragraph below regarding implant caveats*
Removable Prosthodontics – replacement of missing teeth with partial and/or complete dentures
Just because a Veteran is eligible for comprehensive care, it does not guarantee authorization for all available services, and dental implants are a prime example of this fact. Moreover, despite what the media and commercial advertisements may imply, dental implants are not a “cure-all” for every dental compromise:
- They are not better than natural teeth.
- They require just as much, (if not more), regular maintenance than natural teeth. They require exquisite oral hygiene on the patient’s part along with routine dental maintenance visits.
- They can fail just as natural teeth can be lost if not properly maintained.
- They do not carry a guarantee of restorative success, either in the short-term or the long-term. Factors contributing to the success or failure of implants include the patient’s general medical health, personal habits, and ability to perform effective oral hygiene.
No implant therapy is authorized without a Veteran’s case first being presented to our Implant Board. All implant therapies are ultimately authorized or denied at the discretion of the Implant Board, and none will be placed or restored without the Board’s approval. It is the duty of the Implant Board to objectively consider all potential risks and benefits of the proposed implant therapy before authorizing or denying treatment.
There are some therapies not covered by comprehensive dental eligibility:
Esthetics – Although many of our services may improve how your smile looks, no treatments are rendered for the sole purpose of restoring dental esthetics, (e.g., veneers.)
Orthodontics – Tooth straightening (braces) is not covered by VA policy. If you decide to have orthodontic therapy at your own expense, our clinic can coordinate your other dental services in conjunction with your orthodontic therapy.
If you have recently received treatment, either at the facility’s Dental Clinic or by a Community Care provider, and you have questions regarding post-operative care, you are encouraged to click on the links below to review normal expectations and your responsibilities after each treatment.
It is important to understand that you bear the primary responsibility for your oral health and that there is no substitute for good oral hygiene. Our staff will be happy to instruct you on how to care for your teeth and gums. You are encouraged to click on the links below to review good habits that will help you maintain your dental health.
The office of Community Care coordinates dental therapy for Veterans outside the Medical Center for two main purposes:
- Specialist care not available within our clinic – Although the Dental Service offers treatment into all dental sub-disciplines, sometimes it is in the Veteran’s best interest to see a specialist for specific procedures. Some examples of this include:
- Oral Surgery – extraction of teeth; treatment for trauma; treatment for advanced temporomandibular dysfunction (TMJ / “jaw joint” disorders); biopsy of potentially cancerous lesions; surgical placement of dental implants
- Endodontics – root canal therapy
- Periodontics – surgical treatment of advanced gum disease
- Meeting Mission Act mandates – If your commute to the Medical Center is greater than 60 minutes, dental care may be coordinated with providers in the private sector.
Appointments are required for routine dental care. The Dental Service’s normal hours for such care, excluding recognized holidays, are as follows:
8:00 AM to 12:00 PM / 1:00 PM to 4:30 PM – Monday through Thursday
8:00 AM to 12:00 PM / 1:00 PM to 3:30 PM – Friday
Walk-in hours are available each weekday for true dental emergencies which have not been scheduled.
True dental emergencies include:
- Spontaneous tooth pain, i.e., “toothache”
- Swelling inside the mouth or about the face / jaws, especially if it reaches the lower eyelid
- Uncontrolled bleeding from the mouth
- Difficulty breathing or swallowing
The following conditions are not considered true emergencies and should have appointments scheduled to address them:
- Teeth that are temporarily sensitive to hot or cold foods / drinks
- Gums that bleed with brushing and/or flossing
- Denture sores and/or ill-fitting dentures
- Broken teeth, missing fillings, debonded (“loose”) crowns / bridges in the absence of spontaneous pain
Walk-in hours for true dental emergencies are as follows:
10:00 AM to 12:00 PM / 1:00 PM to 2:00 PM – Monday through Friday
If you encounter a true dental emergency on the weekends or outside routine clinic hours, you are encouraged to present to the facility’s Emergency Department for triage.
Your County Health Department is a good resource to locate local and free or discounted Dental Care in your community. In addition, your County Department of Social Services (DSS) can help with enrollment in Medicaid and locating a dental provider who accepts Medicaid.
A list of Dental Providers that accept Medicaid can be seen here:
*Bakersville Community Health Center 828-537-5991
*Blue Ridge Community Health Services www.brchs.com
(Specific contact information is listed by county.)
*Clay County Health Department 828-837-1397
*Good Samaritan Dental Clinic (Burke County) 828-439-9948
*Graham County Health Department 828-479-7901
*Haywood County Health Department 828-452-6701
Haywood Christian Ministries 828-456-4838
(Extractions only – once a year.)
*High Country Community Dental Health 828-406-1925
*Macon County Health Department 828-349-2588
*Madison County Health Department 828-649-2512
NC Dental Society Foundation Missions of Mercy 919-234-4037
(Portable Free Dental Clinics set up as two day events in different locations throughout the state)
*Western NC Community Health Services 828-285-0622
(Located at the Minnie Jones Health Center) www.wncchs.org
During normal business hours, you can reach Dental Service staff by telephone at 828-299-2513. If we are unable to take your call, please leave a message, and someone will return your call as soon as possible.
If your communication is of a less urgent nature, you are welcome to contact us electronically through Secure Messaging on the MyHealtheVet portal. Please address your electronic message to Asheville Dentistry.