Lawmakers consider ways to improve access to dental care

Posted Jan. 11, 2012, at 2:14 p.m.

AUGUSTA, Maine — Mainers should be able to see a new kind of dental professional to improve oral health in the state, according to a study presented to lawmakers Tuesday.

Legislators have been looking into adding a dental provider that could offer services under the supervision of a dentist, much like nurse practitioners and physician assistants work alongside medical doctors.

Introducing new dental providers and allowing existing providers to practice in a wider variety of settings would give more people access to needed care, said Shelly Gehshan, director of the Pew Children’s Dental Campaign. Gehshan presented a national dental care study released by the Institute of Medicine, an independent nonprofit that advises the government on health issues, to two legislative committees.

Most hygienists, for example, are allowed to practice only in a dental office or public health facility, Gehshan said in an interview before the hearing.

“There’s no reason why if you’re a competent licensed provider that you’re not competent somehow if you walk into a nursing home,” she said.

Maine needs about 200 new dentists in the next decade to keep pace with today’s already stretched services, as 40 percent of the state’s practicing dentists are nearing retirement, according to the Pew Children’s Dental Campaign. More than 520,000 Maine residents live in areas federally designated as having a shortage of dentists.

The Maine Dental Association, however, isn’t convinced that work force initiatives are the key to improving access. The group, which represents 580 of the state’s more than 600 dentists, opposes licensing a new type of mid-level dental professional until an ongoing dental access study that grew out of legislation last year is complete, according to executive director Frances Miliano.

“It’s at best premature, until we get the data in,” she said.

A poll released Tuesday by Pan Atlantic Consulting showed more than 78 percent of Maine residents support the creation of a new type of dental provider. The poll surveyed 400 residents from Nov. 9 to 22 and has a 5 percent margin of error.

Legislators have not yet submitted a bill to add the new provider class. They are working to determine the scope of responsibilities it should include.

Miliano also pointed out that the number of new dentists licensed annually in Maine has risen to an average of more than 40 in the last three years, a marked improvement over the previous decade, she said.

The national study presented to the committees Tuesday also recommends that Medicaid pay dentists more fairly and cover dental care for adults, which is now an optional service.

Children are covered for dental care under Medicaid, but 60 percent of kids in Maine on the program didn’t get an exam last year, Gehshan said. One out of five kids in Maine’s third-grade classrooms has untreated tooth decay, she said.

“I can’t imagine sending a kid of mine to school with a toothache and an abscess. I just can’t imagine it,” Gehshan said. “As a mother of two, that breaks my heart.”

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