The first person to be licensed as a dental therapist in Maine has started practicing at a Bangor dental center, seven years after state law changed to allow the new category of dental professional.
The Maine Board of Dental Practice licensed Claire Roesler, 26, as the state’s first dental therapist in a meeting on Friday. She has been working at Penobscot Community Health Care’s Dental Center in Bangor since October, and will continue working there in her new role.
Dental therapists can do many of the same procedures dentists can — including fillings and teeth extractions — though they are not able to do some of the more complex procedures, such as root canals. Dental therapists, who are comparable to nurse practitioners and physician assistants in medicine, also have to be supervised by a licensed dentist.
Maine has long had difficulty keeping native dental professionals in the state for work. Many Mainers start private practices in larger population centers outside the state. Other long time practitioners have retired in recent years.
That makes it difficult for practices across the state to find staff, said Angela Chase, executive division director of PCHC’s dental center.
The dental center itself has encountered recruiting challenges in recent years, and it received help from some Maine nonprofit organizations in recruiting Roesler. The Bethel-based Betterment Fund, the Doree Taylor Charitable Foundation and the Bangor-based Schmidt Institute — a collaboration among area health care organizations — helped pay for Roesler’s recruitment and relocation to Maine.
Chase long advocated for the dental therapy program, seeing it as a way to expand the pool of dental professionals across rural Maine. Dentists generally receive DDS (Doctor of Dental Surgery) or DMD (Doctor of Medicine in Dentistry or Doctor of Dental Medicine) degrees, which take much longer to complete than the master’s degree required of dental therapists.
PCHC’s clinic had been looking to put a dental therapist on staff since then-Gov. Paul LePage signed the legislation authorizing therapists in April 2014.
At the time, the Maine Dental Association, which represents dentists, was strongly opposed, arguing that expanding MaineCare to cover preventive adult dental care was a surer way to expand access to dental care across Maine, including in rural areas. The state’s Medicaid program, MaineCare, currently covers preventive dental care for children and emergency care for adults, such as tooth extractions.
The association also argued that the University of New England’s then-new dental school would supply more dental professionals to the state.
The Maine Dental Association “supports evidence-based, cost-effective solutions that prevent dental disease and help underserved communities get dental care,” Angela Westhoff, the association’s executive director, said Monday. “Research from the American Dental Association indicates that dental therapy programs in the U.S. have failed to significantly improve access to care, rates of decay, or cost of care for patients.”
Chase, at PCHC, also supports expanding MaineCare’s adult dental coverage, for which a proposal is pending before the Maine Legislature. It would allow Roesler to treat even more patients, she said.
While there are some procedures Roesler cannot do, Chase and Roesler said that doesn’t mean she is any less qualified than a practicing dentist. She just has a more narrowly defined scope of practice.
Proponents of dental therapy say the position can help licensed dentists, as they will be able to devote more of their time to complex dental procedures while dental therapists perform others.
“I think there will need to be some education about what a dental therapist even is,” Chase said.
Roesler grew up in Wisconsin, Minnesota and Iowa. She said her upbringing and father’s medical work in rural areas got her interested in caring for patients in underserved communities.
“Living in a rural community truly made me passionate about it,” Roesler said. “Just because you live in a smaller town doesn’t mean that you shouldn’t have high-quality health care.”
After graduating from Iowa State University, she enrolled in the dental therapy program at the University of Minnesota, where she received a master’s in dental therapy.
In 2009, Minnesota became the first state to authorize the licensing of dental therapists. Since then, 11 other states have approved a form of dental therapy. Many of those, such as Alaska and Vermont, have large rural populations.
PCHC’s Dental Center had about 22,000 total visits from 10,000 different patients last year. Patients come to the clinic from as far as two or three hours away, Chase said, and she is looking forward to seeing them work with Roesler in the future.