According to the American College of Prosthodontics 64% of general dentists refer patients to an endodontist and 44% to a periodontist. However state medical/dental benefits, do not offer dental benefits (other than X-rays once a year and extractions) , despite the cost of routine dental care and prevention along with endo care when necessary and dentures or implants for those who have had severe decay due to cancer or a rare disease diagnosis or the treatment causing tooth decay, Medicaid should offer implants, bridges or dentures and not just extractions - for health reasons, and so that people will receive treatment. 

Without proper treatment, then antibiotics and pain medicine is prescribed when the person without comprehensive dental has a filling fall out or an abscess (because without having insurance to help pay for a root canal and crown, no one is just going to have their teeth removed when antibiotics and numbing medicine is the better option- until it happens again)

According to the CDC, when this keep happening, and tooth decay spreads and can cause severe infections, sometimes fatal. Gum disease is the main result of the inflammation and can increase risk to diabetes and cancer.

It seems counterintuitive for the state to stop providing dental care at the age of 19. Dentists in Virginia often schedule cleanings for adults, but take the X-rays and go over a consult by telling them what work they need done before even have a hygienist in to actual do the preventative work. Most adults leave either because they’ve run out of time and need to get back to work or leave out of fear. Regardless they still just have their dental records recorded, not even the bare minimum work of the cleaning, which then further contributes to cavities at first, but it’s not like they have the benefits and it’s not like they received the cleaning they were supposed too, so why would they go back 

Bottom line,Full dental coverage is important for the health, economy, and self - inside and out.  

Add comprehensive dental coverage, or at least implants with extraction coverage, and the endo treatment isn’t necessary, but the problems in between for adults are causing health issues.