February 5, 2013

Study: Mainers lack access to regular dental care

By Kelley Bouchard kbouchard@pressherald.com
Staff Writer

Maine has a shortage of dentists in rural areas, leading many people to go without regular dental care, according to a new report from MCD Public Health.

The report, commissioned by the Legislature in 2011, found that two-thirds of Mainers live in rural areas, but only 13.5 percent of dentists practice in those areas.

Cuts in government-funded dental care have reduced support for prevention programs and sliding-scale subsidies for low-income Mainers, the report found.

Still, 55 percent of kids covered by MaineCare, the state’s form of Medicaid, aren’t getting regular dental care, according to the Maine Department of Health and Human Services.

“You can attribute lack of access to a number of things,” said Margaret Gradie, PhD, program manager at MCD Public Health, a nonprofit that promotes health care initiatives in Maine.

Gradie prepared the report based on a study conducted by the Center for Health Workforce Studies at the School of Public Health at the University of New York in Albany.

Nearly 40 percent of Maine’s 1.3 million people live in federally designated Dental Health Professional Shortage Areas, according to the Pew Center on the States.

Despite the shortage, the center gave Maine’s pediatric dental programs an “A” grade in 2011 and 2012, particularly for its use of dental sealants to prevent decay. Only five states got an A for 2012.

Some worry that the shortage may worsen because nearly one-quarter of Maine’s 676 licensed dentists plan to retire within the next five years, the MCD Public Health report found.

The report also noted that the federal Affordable Care Act is expected to increase demand for preventative oral health services for youths up to age 21 as coverage expands.

“This study paints a bleak picture of access to basic dental care for children in Maine,” Ned McCann, executive director of the Maine Children’s Alliance, said in a news release. “This lack of access hurts kids in the here and now, and compounds future health problems and costs.”

The report is expected to inform lawmakers as they consider ongoing efforts to increase access to dental care, including anticipated legislation that would allow mid-level dental therapists to practice in Maine, said Kathie Summers-Grice, spokeswoman for Dental Access for Me.

Already working in other countries and states, including Alaska and Minnesota, dental therapists have more training than hygienists, so they can do fillings, extractions and other regular dental care under supervision of a dentist.

The Maine Dental Association, however, disputes the need for more dental professionals, according to its vice president, Robert Berube, an Augusta oral surgeon.

The Maine Board of Dental Examiners issued 151 new dental licenses in the last three years, far outpacing retirements, Berube said. He also noted that the University of New England is expected to open a dental college this fall, which is expected to increase the pool of graduating dentists.

Berube said most dentists and dental clinics in Maine are accepting patients, including children on MaineCare, which often doesn’t cover a dentist’s costs.

“There’s no reason why every Maine child isn’t getting dental care,” Berube said. “It’s because parents are bringing their children to the dentist.”

Dentists don’t practice in the most rural areas of Maine because it’s not financially feasible, Berube said, so it wouldn’t be any more profitable for dental therapists, especially when some say there are too many dental hygienists.

Half of Maine’s hygienists reported working 30 or fewer hours per week, nearly 87 percent said it’s difficult to find work and 61 percent said there are too many hygienists, the MCD Public Health report found.

“We need to use the dental workforce that’s already in place and better educate the public about the long-term benefits of regular dental care,” Berube said.

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