CHICAGO — The oral health of older Americans is in a state of decay, and this is particularly true for residents of Maine. Access to dental care is one of the greatest challenges facing older adults and their caretakers, and many of those near retirement are not aware that Medicare doesn’t cover dental care.

While improvements in oral health across the lifespan have occurred in the last half century, there are reasons for serious concern for the 10,000 Americans retiring daily. Only about 2 percent of this “silver tsunami” will have access to dental insurance – and access to dental insurance does not guarantee access to care.

Although much of the debate over unmet dental care needs in Maine has been about low-income children, it is clear that older adults are also in desperate need of care. Older adults face an increased risk for conditions such as loss of teeth, oral cancer and gum disease.

In October, Oral Health America released a state-by-state report card that graded states on a collection of dental care delivery and public health factors affecting the oral health of older adults.

States fell into one of four categories: “excellent,” “good,” “fair” or “poor.” Maine received the lowest rating of “poor” and ranks as the 15th worst state when it comes to the oral health of its older adults.

Maine did score average to well in two of the evaluated areas – community water fluoridation and state oral health plan – but performed poorly in the categories indicating dental coverage and actual, physical access to care.


Specifically, Maine received the lowest possible rating for adult Medicaid coverage, meaning it provided no adult Medicaid dental coverage whatsoever in 2011, according to the Annual Survey of State Medicaid and CHIP Oral Health Programs.

Maine also received the second lowest rating regarding its number of dental Health Professional Shortage Areas, since more than a fifth – or 21.2 percent – of the population was living in areas that qualified as dental HPSAs.

Whether because of geographic location, a lack of facilities, or too large a population designated to one dentist, a significant amount of the population was experiencing – and continues to experience – a shortage of dental professionals and limited or no access to care.

Presently, the problem only continues to get worse. Fifteen of Maine’s 16 counties continue to have dental professional shortage areas. Within the next five years, 23.7 percent of dentists in Maine plan to retire; an additional 16.1 percent expect to reduce their hours. This means the current shortage of dentists will be growing at the same time that the demand for dental services, especially for Maine’s older adults, is on the rise.

Nonetheless, promising solutions do exist. Maine has already demonstrated its capacity to improve its residents’ oral health, and can continue to do so.

Over the past two years, the state has been debating L.D. 1230, An Act to Improve Access to Oral Health Care, which would expand the reach of the dental team using a dental hygiene therapist.

This law would make it significantly easier for people to get care. Dental hygiene therapists would work the way a nurse practitioner or physician assistant works on the medical team, and would provide a unique blend of preventive and routine restorative care, such as filling cavities.

While Oral Health America does not advocate for any particular midlevel model, we do support legislative efforts like this one that expand the reach of the dental team to bring care to those who need it most, and that do so in a financially sustainable way. An expanded dental team will help many thousands of Maine’s residents, including elderly individuals, and children, and low-income or uninsured adults.

Our report reiterated something that many Mainers experience daily: If you are an older adult in Maine – especially if you live in a rural area – dental care is hard to come by. The reasons for this are many, but L.D. 1230, as an evidence-based state solution, is a definite step in the right direction.

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