June 20, 2018
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How to get more Mainers into dentists’ chairs

Juan Carlos Ulate | Reuters
Juan Carlos Ulate | Reuters
Two dentists work on a U.S. patient at a dental clinic in San Jose, Nov. 1, 2012. Around 40,000 medical tourists visited Costa Rica last year, compared to 36,000 in 2010 and 30,000 in 2009. Most of them are American and Canadian, according to the country's tourism institute, ICT. Of that number, almost 15,000 of them traveled for dental care, said Massimo Manzi, director at Promed, the council for international promotion of medicine in Costa Rica.
By Brad Rand, Special to the BDN

We should all be proud that the University of New England opened the doors of its new College of Dental Medicine last week. Over the next four years, the first class of 64 students — including 24 from 11 Maine counties — will receive a quality education and rigorous training in the practice of dentistry.

As a member of the dental community, I welcome the students and applaud them, as well as the University of New England, for bringing comprehensive oral health services to cities and towns across our state.

Maine voters paved the way for the new school when they passed the dental care bond package in 2010. Our investment will allow dental students in the Portland clinic to provide 12,000-15,000 patient care visits each year.

On top of that, fourth-year student externs, under the close supervision of adjunct faculty, will log another 20,000-25,000 patient care visits annually with children and adults throughout rural Maine.

Now is a good time for us to reflect on what is working and determine what more can be done to improve our state’s oral health and, in turn, its overall health.

It is critical that we continue to focus on prevention and assessment. Dentists cannot stress enough the importance of brushing twice daily with fluoride toothpaste, flossing, consuming healthy foods and beverages and visiting a dentist twice each year where preventive services such as dental sealants and fluoride treatments can be applied.

Maine has taken the lead in providing oral health assessments and fluoride varnish to children between six months and three years of age during well child visits with their health care providers.

The state has been recognized as well for its dental sealant program. The Pew Foundation awarded Maine an “A” for how well the state is “protecting kids from tooth decay” in its 2012 report on dental sealants. Maine “earned 11 out of a possible 11 points.”

Programs such as these have helped Maine attain the second lowest rate in the nation of third-grade children with untreated tooth decay, according to state data submitted to the Centers for Disease Control and Prevention.

In addition, many dentists educate children about oral health and provide dental care in schools and programs such as Head Start. Maine dentists also are working to establish a dental module, so the state’s Community Care Teams will direct children to appropriate dental services.

At our practice here in Brewer, my partner and I join with nearly half the dentists in the state in serving patients with MaineCare. We do this even though the state’s reimbursement rates are very low and should be increased.

Children in the MaineCare program have their dental checkups, fillings, extractions and other services covered. For adults, MaineCare dental coverage extends only to emergency care and excludes all preventive care. That is a key reason why so many people are forced to turn to emergency rooms for relief from oral pain. This is a burden on already overworked emergency rooms, which are not equipped for dental cases.

Dentists across the state support the bill in the Maine Legislature that will allow adults covered by MaineCare to visit a dentist once a year for examinations, cleanings and X-rays. An annual visit will identify dental issues before they become emergencies.

Maine dentists have long recognized the exorbitant costs associated with treating dental issues in emergency rooms. To address what is clearly an expensive problem, we are working on an initiative that moves people from hospitals and into dental homes where they will receive more consistent and less costly treatment.

There is plenty of room for patients in Maine’s dental practices and clinics. As is the case with 95 percent of dentists in the state, our practice is accepting new patients. Fifteen Federally Qualified Health Center dental clinics and 11 nonprofit clinics, along with many volunteer clinics that serve as safety nets for patients, are taking new patients, accept MaineCare and offer reduced fees and sliding scale payment options.

Our state’s oral health will be bolstered through the programs and graduates of the new dental school. It can be further strengthened if we commit to expanding proven children’s prevention and assessment programs and funding programs that encompass more adults.

Dr. Brad Rand is a dentist practicing in Brewer. He is a member of the Maine Dental Association.

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