Maryland Kinship Care Dental Consent for Grandparents and Relatives

You take a child to the dentist for a cleaning, and the front desk asks who has custody. You don't — you're a grandparent or aunt or uncle who stepped in when a parent couldn't be there. The receptionist wants a signed consent form, and the parent isn't available to sign one.

Maryland law handles this. The same Health-General § 20-105 affidavit that covers medical treatment also covers dental care, from routine cleanings to fillings to orthodontic consultations. Here's how to use it.

The Health Affidavit Covers Dental Care

The Consent for Health Care Affidavit — Form DHS/SSA/554, published by the Maryland Department of Human Services — authorizes a relative caregiver to consent to healthcare services broadly. That includes dental exams, cleanings, fillings, X-rays, and routine orthodontic care.

You don't need a separate dental consent form. The same affidavit you file for pediatric checkups and vaccinations works at the dentist's office.

To use this affidavit, three things must be true:

• You're related to the child within the fifth degree of consanguinity or affinity (grandparent, aunt, uncle, great-aunt, adult sibling, first cousin)
• The child lives with you full-time, 24/7
• The arrangement exists because of one of six qualifying hardships: death, serious illness, drug addiction, incarceration, abandonment, or an active-duty assignment in the uniformed services

How to Present the Affidavit at a Dental Office

Most dental offices haven't encountered a kinship care affidavit before. Bring a notarized copy and explain that it's a state statutory instrument under Health-General § 20-105 — not a homemade permission slip.

Practical steps:

1. Call the dental office before the first appointment and mention you'll be bringing a state health care affidavit instead of a parental consent form
2. Bring the original notarized DHS/SSA/554 form and at least one copy
3. Ask the office to scan the affidavit into the child's patient file
4. Request a stamped receipt or written acknowledgment that the form is on file

If the office refuses, ask for the refusal in writing with a specific reason. Then contact the DHS Kinship Navigator Program at (800) 332-6347 for guidance, or escalate to the dental practice's patient advocate or compliance officer.

What Dental Treatment the Affidavit Doesn't Cover

The affidavit authorizes dental care within its scope, but it does not override a parent's explicit objection or a court order assigning health care decision-making to someone else. If a parent contacts the dental office and objects to treatment, the affidavit is overridden.

Maryland law allows emergency medical or dental treatment without prior consent when immediate treatment is necessary to prevent substantial risk of death, serious physical harm, or severe impairment of the child's health, and delaying treatment to obtain consent would adversely affect the child's life or health.

Dental Insurance and Medicaid Coverage

The health care affidavit also authorizes you to apply for public health insurance on the child's behalf. The Maryland Children's Health Program (MCHP) — the state's Medicaid program for children under 19 — covers dental services including preventive cleanings, fluoride treatments, sealants, fillings, and extractions.

Apply through Maryland Health Connection or your local Department of Social Services. You don't need legal custody to enroll the child; the DHS/SSA/554 affidavit establishes your authority to apply.

If the child already has dental coverage through a parent's plan, you can use that too. Bring the insurance card along with your affidavit.

Keep a Dental Records Folder

Track every dental visit in a simple log: date, provider name, treatment performed, and what you consented to. This record matters for two reasons. First, it documents the care you've arranged, which protects you. Second, if the child returns to a parent or transfers to another caregiver, the records transfer smoothly.

Our Maryland School and Medical Consent Guide includes a Medical Provider Notification Log designed for exactly this — tracking which providers have your affidavit on file and what care has been authorized.

The affidavit renews annually. When you re-file, update every dental office that has the old copy on record.

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