Question 2: helping Maine control dental care costs

Posted Oct. 26, 2010, at 7:40 p.m.

On Friday, the Bangor Daily News published an editorial suggesting that Question 2 on the November ballot receive a no vote. While I have a tremendous respect for the BDN and its editorial staff, I wish to offer the readers another perspective.

I have had the privilege of serving a health center in Maine for the past 13 years. The health center model is to offer access to high-quality, comprehensive and integrated care without refusal because of inability to pay. That includes oral health as well as medical and behavioral health. We treat the whole person — head to toe, psychiatry to podiatry. Medical care does not stop at the shoulder — the head is connected to the body.

Eight years ago, we at Penobscot Community Health Care began dental services with one dentist, one dental assistant and one dental hygienist and a waiting list of more than 4,000 Maine people. We have been fortunate enough to expand our dental services and currently have more than 12,000 dental patients. However, we are not able to fill the current need, and neither are countless other health centers and dental clinics across rural Maine.

That’s because Maine has a dental crisis. While nationally there is one dentist for every 1,600 people, Maine has one dentist for every 2,300 people. The result: Nearly 250,000 Maine residents do not have dental care, and the gap is expected to widen as dentists retire over the next decade — 40-plus percent of Maine dentists are now over the age of 55.

Another chilling fact: The No. 1 reason people age 18 to 44 who do not have insurance or who are on MaineCare show up in emergency rooms is dental pain. Think about that for a minute — dental pain. And the only treatment available is to help ward off the pain by prescribing pain medication and an antibiotic, but medications do not fix the problem.

In 2006, there were 12,000 such visits, and the cost for those visits approaches $7 million. That’s right, $7 million — and the dental problem was not fixed.

If we want to address Maine’s dental crisis, we can’t count on just hoping for more dentists; we need to be proactive.

Question 2 asks the voters to approve a “one-time” expenditure of $5 million. What does that buy? The bond includes $3.5 million for a teaching clinic and $1.5 million for expansion or creation of additional dental space in nonprofit community clinics.

By voting yes, we will see creation of a school of dental medicine in Maine and the expansion of dental care statewide. This dental school will recruit students from Maine schools and colleges who now have to leave the state to study dentistry. It will be a school that places its fourth-year students in the community clinics all across Maine for a minimum of six months or, in many cases, for the entire year.

Research has shown that students tend to stay in the communities where they trained. They become invested in the fabric of the community. We know this firsthand because Maine’s only medical school has provided 25 percent of its graduates as practicing physicians in rural Maine.

We are pleased that the Maine Dental Association and dozens of other organizations dealing with health care issues have endorsed this initiative. Also, I have spoken personally to each gubernatorial candidate, and each has endorsed this as a win-win for Maine’s people.

It will provide more than 60,000 dental visits in the teaching clinics each year, high-paying jobs — as faculty, hygienists, dental assistants, receptionists and clerical support — and economic benefit to the state while stemming Maine’s oral health dilemma.

We believe the people of Maine are very frugal and wise. We believe they know the reality — poor oral health has a lifetime of negative consequences — and we believe they know firsthand the difficulty of getting access to affordable dental care. We also believe they can sense a great deal when they see it, and this is a great deal for Maine.

Please vote yes on Question 2 on the November ballot.

The Rev. Bob Carlson is the president of Penobscot Community Health Care.

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