The recent closing of Bangor’s oral health program should be a source of concern for us all. While the reasons for closing the program make sense from the short-term financial view of the Bangor City Council, the long-term financial and public health implications are alarming.
The Bangor program focused on preschoolers in the Head Start program. It provided free preventive care and education to parents and children — to get them on the right track for a lifetime of healthy teeth and gums. This care is critical to preventing future dental disease and the attending costs.
There may have been many reasons for closing this important program but two certainly played a role — MaineCare did not provide adequate funds to cover basic expenses, and the program was underused.
The recent report of the Governor’s Task Force on Oral Health Care recommended, as a first priority, the need to increase MaineCare funding for dental care. The task force noted that the increase could significantly enhance access to oral health care in Maine.
The task force recognized that the low MaineCare rates, which do not cover the cost of providing the service, mean that both public and private dental facilities lose money by treating MaineCare clients.
Maine dentists are willing to do our share, even for free. Last year, the Maine Dental Association estimated that Maine dentists provided over $8 million worth of free care. And yet, even with this, a good number of Maine people do not receive adequate dental care.
Another reason the Bangor program was closed is that though the program was free, it was underutilized. In this program, children had access to excellent care, but there were too few takers. This is an important point we cannot ignore as we work to expand access to care.
Some argue that the access issue can be solved simply by increasing the number and types of dental professionals. We must be extremely cautious in implementing this, lest we risk the quality and safety of patient care. Increasing the number of licensed dentists in Maine is part of the solution and to that end, MDA has a variety of programs aimed at bringing more dentists here.
For example, last year MDA was the champion of a new law that provides tax incentives for dentists to establish practices in rural areas of the state. MDA also offers scholarships to Maine dental students, is working with high school guidance counselors to encourage more students to enter the dental professions and has a net-work of dental school outreach programs aimed at highlighting the advantages of living here.
If we are to move forward to ensure all Maine people receive basic oral health care, then we must draw lessons from Bangor’s closure and use them to build a better experience and include it in our problem-solving. Clearly, MaineCare funding rates must be raised. And clearly, education about the importance of early prevention must be enhanced.
A coalition of dental organizations is supporting legislation this session to increase the MaineCare reimbursement rates for oral health care. I hope the Bangor experience will guide legislators to an understanding that a rate increase is, in the end, a cost-saving approach. Every Bangor child who will now not receive early preventive care will undoubtedly cost more to treat in the future.
Improving access to care is not a simple issue with a simple solution. It requires an integrated and thoughtful approach that unfortunately will take time, money and a commitment from the public officials, health professionals, schools, parents and, really, all of us. The MDA looks forward to continuing to work with state policy makers on this very important issue.
Dr. James Schmidt is president of the Maine Dental Association.