Rural Mainers struggle to access dental care, report finds

Posted Feb. 05, 2013, at 1:50 p.m.
Last modified Feb. 05, 2013, at 4:37 p.m.

Rural Mainers, including children covered by the state’s Medicaid program, face critical barriers to dental care, according to a report released this week.

Commissioned by the Maine Legislature in 2011, the report by Augusta-based MCD Public Health found that 55 percent of children covered by MaineCare lack access to dental care despite having government-sponsored insurance. The report also found that while two-thirds of Maine residents live in rural areas, just 13.5 percent of dentists practice in those regions.

Fifteen of Maine’s 16 counties — all but Sagadahoc — face a shortage of dentists, which will be exacerbated with nearly one in four dentists planning to retire in the next five years, according to the report.

“This study paints a bleak picture of access to basic dental care for children in Maine,” Ned McCann, executive director of the Maine Children’s Alliance, said in a news release announcing the report. “This lack of access hurts kids in the here and now, and compounds future health problems and costs.”

The study grew out of a legislative debate about improving oral health in Maine, including whether to add a new class of dental professionals that could offer services under the supervision of a dentist, much like nurse practitioners and physician assistants work alongside medical doctors.

Most hygienists, for example, are allowed to practice only in a dental office or public health facility, but not in a nursing home, school, or other setting.

Supporters of a midlevel dental practitioner plan to again file legislation to create a dental hygiene therapist position in Maine to help address the dental workforce shortage problem, according to the release.

The Maine Dental Association, which represents 580 of the state’s more than 600 dentists, has said previously that it opposed licensing a new type of midlevel dental professional until the study was complete, questioning whether workforce changes were the key to improving access to dental care in the state.

On Tuesday, Dr. Robert Berube, vice president of the Maine Dental Association, said the MCD report underscored that Maine already has enough dental professionals.

The problem is that patients aren’t aware of the state’s existing capacity among dental health practices, including 15 federally funded dental clinics that are all accepting new MaineCare patients.

“We have the pediatric dentists willing to see them,” Berube said. “We just need to get them there.”

Maine licensed 116 new dentists over the last two years and 95 percent of dentists are accepting new patients, he said.

“Most importantly, this study provides a roadmap to help us further develop a diverse workforce, both in geography and skill set, with the aim of improving access to care in Maine’s dental health professional shortage areas,” Vanessa Santarelli, CEO of the Maine Primary Care Association, said in the release, issued by the Dental Access for ME coalition.

MCD Public Health’s report relied heavily on the findings of a study by the Center for Health Workforce Studies at the State University of New York Albany’s School of Public Health.

It also predicted that demand for preventive oral health services will rise as the national health reform law takes full effect and provides coverage to youth up to age 21.

MCD Public Health, created in 1966, works with communities, organizations, and government agencies to create and implement public health programs and policies.

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