Forget a minor cavity or sore gum—unemployment, malnourishment, emergency room visits, and even death can all be symptoms of not having access to affordable dental care.

"We tend to think of dental care as an afterthought...but it's very important," said Don Berwick, former Administrator of the Centers for Medicare and Medicaid services and a senior fellow at the Institute for Healthcare Improvement.

Berwick ticked off a list of for untreated dental issues, especially for children and the elderly: "There's the chronic burden of pain, malnutrition, kids with dental problems that aren't treated well will have trouble attending schools and for elders, people in nursing homes, it can be truly life-threatening," he said.

Yet in Massachusetts, low-income residents are not getting the dental care they need. Almost half of the children on Medicaid in Massachusetts—about 300,000 kids—did not see a dentist at all in the year 2014. 

"We don't have a dentist to go around...and we should work on that," Berwick said.

Berwick points to a bill recently proposed in the state legislature that could make inroads on this issue. The proposal would create a midlevel dental professional in the state, similar to the role a Nurse Practioner or midwife plays in other fields, with a required level of training and accreditation. Both Alaska and Minnesota have implemented similar programs.

These midlevel professionals couldn't do everything a dentist could do, but they can fill cavities, extract teeth that can't be saved, and perform simple restorative procedures—and sometimes those things make all the difference.

"It is the best way I can think of to provide access for underserved people right now," Berwick said.

To hear more from Don Berwick, tune in to Boston Public Radio above.