Bill to allow hygienists to open clinics wins bipartisan support, but dentists question the strategy

Posted April 10, 2013, at 8:31 p.m.
Last modified April 10, 2013, at 9:16 p.m.

AUGUSTA, Maine — A coalition that has unified some Republicans and Democrats around expanding access to dental care in Maine launched an effort Wednesday to allow a new type of dental provider to operate practices in the state.

The Dental Access for Maine coalition says allowing dental hygiene therapists — who can perform some procedures normally performed by dentists, like fillings and extractions — would fill a void in Maine, especially in remote areas of the state where access to dentists is limited.

A public hearing is scheduled Thursday for the bill the coalition is supporting, LD 1230. The legislation is sponsored by House Speaker Mark Eves, D-North Berwick, and co-sponsored by more than 40 Republican, Democratic and independent legislators.

“No one should have to get their dental care in an emergency room,” Eves said at a State House news conference where Sen. David Burns of Whiting and Rep. Heather Sirocki of Scarborough, both Republicans, also spoke.

The bill would set up a license for a dental hygiene therapist that would require a therapist to graduate from a dental hygiene therapy program and complete 500 hours of clinical training supervised by a dentist. A hygiene therapist would be allowed to operate a practice in Maine as long as he or she has a supervisory agreement with a licensed dentist.

Dental hygiene therapists already practice in Alaska and Minnesota.

“I believe this is the right approach to address a dental health need throughout the state and Washington County,” Burns said at Wednesday’s news conference.

Supporters cited statistics from a report commissioned by the Legislature in 2011 and released in February that found only 13.5 percent of dentists practice in rural areas, yet two-thirds of Maine residents live in rural areas. The report also found nearly a quarter of Maine dentists plan to retire in the next five years, and 16 percent expect to reduce their hours.

In addition, the report found that an existing dental hygienist license that allows hygienists to open independent practices has started to alleviate some of the dental care access problems in rural areas.

Allowing dental hygiene therapists in Maine won’t address one of the major underlying problems that affects the oral health of Maine’s population, said Jonathan Shenkin, a pediatric dentist in Augusta and a member of the Maine Dental Association, which is opposing LD 1230.

MaineCare, the state’s version of Medicaid, covers comprehensive dental care for children — and Maine recently was one of five states to receive top marks for children’s dental care from the Pew Charitable Trusts. For adults, MaineCare only covers costly emergency dental procedures. And the legislation to create dental hygiene therapists doesn’t address the MaineCare funding situation.

“We don’t have any money to pay for these dental clinics,” Shenkin said. “If you don’t fund it, people are going to continue going to the emergency rooms.”

Since there’s no MaineCare funding for adult preventive dental care, Shenkin said, that means there would be a limited funding stream to support clinics operated by dental hygiene therapists.

As for access to dentists, Shenkin said efforts are in the works to address that problem in Maine. The University of New England’s new dental school is set to welcome its first class in the fall, he said, and that class will include 23 Maine residents from 11 counties.

“We have an answer,” Shenkin said. “It’s starting in the fall.”

Shenkin also questioned whether dental hygiene therapists would open practices in high-need areas in Maine. Dental hygienists who have opened independent practices have tended to locate in areas where dentists are practicing.

But Sirocki, a dental hygienist, said there are a number of unemployed dental hygienists in Maine’s rural areas who would sign up for the dental hygiene therapist training and open up shop in high-need areas.

“They’re looking for work,” she said. “This is a career path for them, and they’d be highly motivated to serve their hometowns.”

While members of both parties have signed on to the initiative, it doesn’t yet enjoy the support of Gov. Paul LePage. Asked about the bill during a Southern Midcoast Maine Chamber luncheon in Brunswick on Wednesday, the governor said he needs to find out more.

“I’m aware of it,” he said. “I’m concerned about it.”

BDN Business Editor Whit Richardson contributed to this report.

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