June 24, 2018
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New dental provider won’t improve Maine’s oral health. Prevention, getting to appointments will

George Danby | BDN
George Danby | BDN
By Dr. Jeremy Zobel, Special to the BDN

The need for adequate dental care for children and adults in Maine is great. I know because I am a 31-year-old dentist practicing at one of Maine’s Federally Qualified Health Center dental clinics, Health Access Network in Lincoln. It’s also called a safety net clinic because it provides services to underserved children and adults.

I came to Maine because I heard that areas of the state had a shortage of dentists, and I wanted to help people, to treat people who might otherwise go without dental care. Immediately after graduating from dental school, I took a huge risk and moved here. I put off marriage and starting a family. I borrowed money to purchase a home. Maine is the place I chose to begin my career, invest my time and where I want to raise my family.

As a dentist who accepts MaineCare with no limitations and treats any patient regardless of the ability to pay, I thought I’d be very busy at a clinic in a rural town in Penobscot County.

But, despite our best efforts, the no-show and cancellation rates at the Lincoln clinic remain very high. We have the capability and infrastructure to see far more patients. As a matter of fact, we recently expanded services to Lee. We even accept fees based on a sliding scale, structured on patients’ income levels.

Unfortunately, we’ve found that despite a history of two dentists at the clinic, the demand for services requires just one dentist, and my schedule has been much less full than I’d like.

The Lincoln dental clinic is open five days a week. No one is turned away, and I don’t go home until everyone is seen. We work with the local hospital, treating underserved patients referred to us. Unfortunately, some of these same patients repeatedly return to the hospital even when our clinic is open.

If legislators really want to improve oral health in Maine, let’s cover routine, preventive dental care for adult MaineCare recipients instead of paying for expensive extractions and surgeries that could have been prevented.

The pediatric dental residency program in Bangor, where eight pediatric dentists are available to treat nearly all children, is unsustainable and closing soon. The reason? In a news report, the dental director stated that there were too many empty dental chairs, kids not getting to their appointments and parents not participating in preventive care. I see this same trend nearly every day at my clinic.

Speaker of the House Mark Eves is pushing a bill to create a new type of dental provider. How will this solve any issues?

Many of the children I refer to pediatric dentists miss their appointments. Pediatric dentists have much more training and experience than I. Often they have hospital and sedation privileges; certainly these children couldn’t be treated by a dental therapist.

Dental disease is preventable. Why is the speaker so focused on creating a dental therapist when what we really need to do is talk about prevention and make sure patients get to their appointments?

I ask these questions because a lot what is being said makes me feel like the work that I and so many other dentists do to treat Maine’s underserved is meaningless.

The dentists who “camped out” at the Legislature are part of the front line of oral health care in Maine. Yes, many of us, including young dentists employed by nonprofit clinics and FQHCs who took time off without pay, came to the State House to talk to legislators. There was not one among us who was there to “cloud the waters,” as Eves claimed in a Dec. 11 BDN OpEd. We were there to talk about what we know — quality dental care.

If the speaker is looking to scare away all of Maine’s young dentists and the future graduates of Maine’s new dental school, I honestly have to say creating a new provider type will do it. Maine taxpayers had a hand in starting this school, and certainly we owe it to ourselves to let it mature in its mission to increase dental care across this state.

All legislators have an open invitation to visit the clinic in Lincoln, to see firsthand what dentistry is like at one of Maine’s safety net dental clinics.

Dr. Jeremy Zobel, DDS, is a licensed dentist practicing in Lincoln.

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