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Federal Regulations

Sub Section 483.55 of the Code of Federal Regulations Title 42, the Department of Health and Human Services defines the actions and responsibilities of skilled nursing facilities regarding the routine and emergency dental care to be provided to their residents.

Federal Regulations Demand Action!

  • 42CFR 483.55(a) Requires skilled nursing facilities to provide or obtain routine and 24-hour emergency dental care
  • 42CFR 483.20(b)(xi) Requires the facility to conduct initial and periodic dental assessments
  • 42CFR 483.75(h) Requires that if a dentist is not on staff, the facility arrange to have one under an agreement with the facility

“The intent of this regulation is to ensure that the facility be responsible for assisting the resident in obtaining needed dental services, including routine dental services.”

§483.55 Dental Services

The facility must assist residents in obtaining routine and 24-hour emergency dental care.

§483.55(a) Skilled Nursing Facilities

A facility—

(1) Must provide or obtain from an outside resource, in accordance with §483.75(h) of this part, routine and emergency dental services to meet the needs of each resident

(2) May charge a Medicare resident an additional amount for routine and emergency dental services

(3) Must if necessary, assist the resident in making appointments and by arranging for transportation to and from the dentist’s office

(4) Promptly refer residents with lost or damaged dentures to a dentist


  • “Routine dental services” means an annual inspection of the oral cavity for signs of disease, diagnosis of dental disease, dental radiographs as needed, dental cleaning, fillings (new and repairs), minor dental plate adjustments, smoothing of broken teeth, and limited prosthodontic procedures, e.g., taking impressions for dentures and fitting dentures.
  • “Emergency dental services” includes services needed to treat an episode of acute pain in teeth, gums, or palate; broken, or otherwise damaged teeth, or any other problem of the oral cavity that required immediate attention by a dentist.
  • “Prompt referral” means, within reason, as soon as the dentures are lost or damaged. Referral does not mean that the resident must see the dentist at that time, but does mean that an appointment (referral) is made, or that the facility is aggressively working at replacing the dentures.