It bears repeating that dental care is health care. Study after study has demonstrated the long-term health benefits of regular dental visits. Routine dental care can prevent the need for more serious and more expensive procedures in the future.
In January, we were making these points in support of a bill to expand routine dental coverage to more low-income Maine people by requiring the state’s Medicaid program to cover it. That legislation, unfortunately, was put on hold when the Legislature suspended its session because of the coronavirus pandemic. But that’s far from the only thing that’s been on hold for Maine’s dental practices and the people who need to access those services as a critical part of their health care.
Routine dental care has been paused in Maine because of the pandemic, with dental practices currently limited to providing emergency care. The initial pause was a reasonable step to slow the spread of COVID-19. After all, we’re talking about working in someone’s mouth during a global pandemic caused by a virus that can spread through respiratory droplets. But Maine opened the door to routine medical procedures at the beginning of May, and it’s once again time to recognize that dental care is health care as the state continues its phased economic restart.
Dentists are right to raise the alarm about the impact this pause can have on patient health. For example, South Portland oral surgeon Dr. Killian MacCarthy told the Portland Press Herald that he’s seen an increase in surgeries for cases of deep jaw infections.
“If [dentistry] were closed for only two weeks, it’s not much of a problem, but it’s been two months now and things are about to blow up,” MacCarthy said.
Leading up to this week, the dental reopening guidance from the Mills administration has included conflicting messages and confusion. This whole process, and apologies in advance, has been a bit like pulling teeth — not only for Maine dentists and their employees trying to figure out and plan for when they can reopen, but for state officials in Maine and elsewhere who are trying to sort through inconsistent guidance from the federal government and the industry.
The U.S. Centers for Disease Control and Prevention, as of guidance provided April 27, has recommended that dental work continue to be limited to emergencies. But the American Dental Association has developed its own guidelines to help dentists resume non-emergency procedures safely. Based on information from the ADA, Maine has been relatively slow to return to routine dental care compared to other states. It’s far from outrageous, however, that the state has been looking to the CDC for clarity.
That apparently is in the works, with CDC director Robert Redfield telling Sen. Susan Collins during a Tuesday hearing that his agency is working with dentists and state officials to update its guidelines.
“Dentists tell me that teeth with cavities that could have been filled are now going to need root canals. Teeth that could have been treated with root canals are now going to require extractions. People with oral cancers cannot get the treatment, the cleanings, that they need before beginning their treatment,” Collins told Reidfield. “Dental health is clearly so important, and Maine state officials as well as our dentists, are seeking assistance in reaching the right decisions.”
She asked him if it would be reasonable for states, as they look at reopening dental practices, to consider whether dentists are following ADA guidelines, instituting strict protective measures, and closely monitoring COVID-19 cases in their areas. He agreed that it would be.
Later that same day, Maine Department of Health and Human Services Commissioner Jeanne Lambrew announced that if the U.S. CDC doesn’t provide new guidance by May 18, the state will defer to guidelines from the ADA and Maine Dental Association.
“We at the department care as much about dental services as all other health care services. We know oral health is critical to people’s mental health, physical health and just their wellbeing,” she said, stressing that people should still be seeking care for urgent dental issues.
With Lambrew’s announcement Tuesday, it seems the state has heard and is working to respond to the concerns raised by dentists. Surely it hasn’t been as fast as some would have liked, but the key now is ongoing collaboration between the state and industry to make sure the reopening is as safe as possible for patients, dentists and their employees.
And now, maybe more than ever, it should be clear that dental care is health care, and that policymakers, insurance companies and the general public need to continually approach these services with that in mind.