AUGUSTA, Maine — The Maine Senate on Thursday voted to advance a bill to license mid-level dental professionals to perform routine oral health procedures.
Proponents of LD 1230, sponsored by House Speaker Mark Eves, D-North Berwick, and dozens of lawmakers on both sides of the aisle, say the bill would boost access to oral health care in a state where 15 of 16 counties have a shortage of dentists and many low-income children go without preventive care.
The Senate voted 19-16 to give the bill initial approval. The House on Tuesday voted 102-39 to support the bill. Additional votes are needed in both chambers before the bill is sent to Republican Gov. Paul LePage for his signature or veto.
A second vote in the Senate was postponed Thursday by Senate Majority Leader Troy Jackson, D-Allagash, who opposes the measure. This allows more time for conversation among lawmakers, during which time opponents will try to win more support for their side.
LD 1230 would establish a new state license for “dental hygiene therapists,” who could perform routine dental procedures such as cleanings, tooth extractions and fillings. The therapists would have more training than dental hygienists but less than dentists. Advocates say the position is to dentists what nurse practitioners are to medical doctors.
Under the law, the dental therapists could operate their own clinics, but they must hold a supervisory agreement with a licensed dentist. They would be allowed to operate in schools, nursing homes and assisted living centers. They would also be required to undertake additional education of at least 1½ years, 1,000 supervised clinical hours and pass an examination by the state Board of Dental Examiners.
The idea is that services provided by dental therapists would cost less than those offered by dentists. Under the law, 50 percent or more of patients served by therapists must be MaineCare recipients.
Dental therapists are relatively rare in the United States. Only Alaska and Minnesota currently provide such licenses, though they are more common internationally. Roughly 50 countries employ similar types of dental professionals, including Canada and Great Britain.
Advocates say the new licensure is needed because dentists are hard to come by in rural parts of the state, and many of the state’s dentists are nearing retirement. More than 20 percent of the state’s dentists plan to retire in the next five years, and an additional 16 percent plan to reduce their hours, according to research cited by a coalition of the bill’s proponents.
The law has faced firm opposition from Maine’s dentists, who have lobbied hard against its passage. They say the problem of access to dental health care in rural Maine has been exaggerated, and efforts to attract more dentists to the state — including the opening of a new dental school at the University of New England — are addressing whatever shortage does exist.
An earlier version of the bill met its death in the Senate last year, when the upper chamber of the Legislature voted 14-21 to oppose the proposal.
The Senate is expected to conduct its second vote on the bill on Tuesday. If they approve it, it heads back to the House for another vote before going to the governor.
Follow Mario Moretto on twitter at @riocarmine.