June 22, 2018
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House votes 95-45 to allow dental hygienist therapists to open practices

By Matthew Stone, BDN Staff

AUGUSTA, Maine — The Maine House gave initial approval Tuesday to a bill that would allow a new type of dental provider, a dental hygiene therapist, to open up shop in the state and address what the bill’s supporters call a shortage of access to dental care in Maine.

The House voted 95-45 to pass the bill, LD 1230, which has been heavily lobbied by dentists opposed to it, and a coalition working to pass the bill that has attracted support from members of both parties. The bill is sponsored by House Speaker Mark Eves, D-North Berwick, and is co-sponsored by more than 40 lawmakers from both parties.

“We have a dental shortage,” said Rep. Heather Sirocki, R-Scarborough, a dental hygienist and bill cosponsor. “Some believe this. Others don’t.”

The bill would establish a license for a dental hygiene therapist that would require a therapist to graduate from a dental hygiene therapy program and complete 1,000 hours of clinical training supervised by a dentist. A hygiene therapist would be able to perform some procedures normally performed by dentists, like fillings and tooth extractions, and be allowed to operate a practice in Maine as long as he or she has a supervisory agreement with a licensed dentist.

The bill passed by the House would require that 50 percent of patients served by dental hygiene therapists be recipients of MaineCare, the state’s version of Medicaid, the government health insurance program that serves low-income and disabled residents.

Dental hygiene therapists are a relatively new profession in the United States. So far, they’re only recognized in Alaska, where they practice in federally designated tribal areas, and Minnesota.

Debate on the House floor Tuesday centered largely on whether Maine has a dental care shortage.

Bill supporters told stories of constituents, friends and foster children who have had trouble finding dentists who are accepting new patients, much less accepting patients with MaineCare or no insurance. They noted that 15 of Maine’s 16 counties have federally designated Health Professional Shortage Areas for dentists, nearly a quarter of Maine dentists plan to retire in the next five years and 16 percent expect to reduce their hours.

“The solution remains expanding the scope of practice for the dental hygienist,” said Rep. Anne-Marie Mastraccio, D-Sanford. “It’s time for action.”

Dentists have lobbied hard against the measure, saying the statistics showing a shortage of access to dental care have been exaggerated. A report on oral health care in Maine commissioned by the Legislature in 2011 and released in February originally stated that only 13.5 percent of dentists practice in rural areas, while two-thirds of the state’s residents live in those areas. That statistic, however, has since been removed from the report because it confused different federal definitions of “rural.”

According to the Maine Dental Association, the correct statistic would show 25 percent of Maine residents — not two-thirds — live in the rural areas where 13.5 percent of dentists practice.

Rep. Lawrence Lockman, R-Amherst, said Maine’s dental problems don’t have to do with a lack of access to dentists. MaineCare recipients, he said, frequently book appointments and don’t show up.

“We have a personal and parental responsibility problem,” he said. “I say that we need to figure out why people aren’t going to the dentist rather than blaming the dentist for why people aren’t going. I know there are dentists accepting new patients, and I know they accept MaineCare.”

The Maine Dental Association has also argued that a new dental school at the University of New England in Biddeford, which will enroll its first class of prospective dentists in the fall, will help to address some of Maine’s dental access problems.

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