A woman in Levant lost all her teeth and worries that her broken dentures will fall out at work; now she sees her college-age daughter starting to go through the same things.

One patient of a Bangor physician struggles with teeth infections while pregnant, raising the chance of pre- and post-natal complications; another has lost teeth, preventing her from following a diet that keeps her diabetes in check.

An Auburn mother of two has broken and missing teeth that leave her in constant pain and make worse her other health problems.

You can’t hear these stories, all given as testimony before the Legislature, and not see that dental care is as necessary as medical care – that dental care is medical care. Yet Maine is one of 14 states whose Medicaid program doesn’t treat it that way.

After two years of effort, that seems likely to change this legislative session – and for good reason. There are no shortage of stories from Mainers living without dental insurance who have watched helplessly as small problems turned into big ones for lack of care, leading to constant pain, infections and pulled teeth. They are left susceptible to various chronic conditions and embarrassed by their appearance. The physical and mental toll is enormous.

Not only does poor oral health make one’s life miserable, it also comes at a great cost to the rest of us, not only from the inevitable emergency room visit – Maine’s Medicaid program does cover some procedures, like extractions, but only once things get really bad – but from the loss of productive community members.

For the mother in Auburn, the lack of access to care has made her reluctant to participate in her community and in the workforce in the ways she would like to. “I could be doing so much more if I wasn’t struggling so much with my physical health, mental health and especially my dental health,” she told a legislative committee last month.

It’s simply absurd to treat oral care any differently from how we treat care for the rest of the body. MaineCare, the state’s Medicaid program, doesn’t deny a patient blood pressure medication and tell them to come back when they’ve had a stroke.

And it shouldn’t do the same with dental care, waiting until pain, infection and the loss of teeth have wreaked havoc on someone’s health, self-esteem and prospects in the workforce to do anything at all.

As the woman from Levant told lawmakers, all that delay does is make it more difficult for someone to get out of the circumstances that led to the problems in the first place.

“The cycle of poverty is a central reason why dental is so inaccessible,” she said. “My daughter will be blocked from getting ahead because our health care system does not see dental health as part of our overall health.”

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