The addition of dental coverage to MaineCare benefits already is changing lives for the people who are finding care after years of having to put it off.
And it’ll do the same for tens of thousands of others – once Maine solves a problem vexing so many rural states.
There were not enough dentists, hygienists and other dental health professionals in the state before COVID-19, and the pandemic didn’t help matters. As the Press Herald reported this week, Maine had just 510 dentists practicing in 2021, the latest year statistics were available, down from 590 in 2019.
According to the U.S. Department of Health and Human Services, more than 370,000 Mainers live in areas with dental provider shortages. Pew Charitable Trusts says 15 of 16 counties have a dentist shortage.
Community Dental, which has six offices in Maine, announced last week that because of an inability to fill hygienist positions, it would be closing two offices in underserved areas, Rumford and Monson.
No wonder many of the more than 220,000 residents who became eligible for MaineCare dental benefits in July are having trouble getting an appointment. Not only are there fewer dentists who are now trying to catch up on care missed during the pandemic, many of them are wary about taking Medicaid patients, for whom services are reimbursed at only a two-thirds rate.
Maine is not alone in this predicament. Particularly in rural areas, dental care is difficult to find, the result of the low reimbursement rates and the necessity of dental school graduates to pay back the hundreds of thousands of dollars in debt they typically incur to get a degree.
It’s likely more providers will be able to take on MaineCare patients as time goes on. But other avenues have to be explored.
Solutions are being tested out here and there. Maine offers loan forgiveness, but it could be more robust. University of New England’s dental school, the only one in the state, will turn out more grads next year than this year in an effort to increase providers. The school also has fourth-year students serve a rotation in a rural or otherwise underserved area, where they provide care and maybe think about establishing a practice later on.
The answer isn’t only more dentists, however. Maine can help relieve its shortage by helping patients use the services available more efficiently.
State lawmakers in 2014 authorized dental therapists to perform both preventive and routine restorative care. Not only does that instantly create more providers who can do the work, it also frees up dentists to perform more complex procedures.
This model can be used elsewhere. For instance, a lot of people who are now not receiving care could be served by hygienists consulting with a dentist over telemedicine.
Maine did the right thing by expanding dental coverage to its poorest residents. It removed a massive barrier to health care that was affecting tens of thousands of residents.
Given the complexity, and shortfalls, of our health care system, it’s no surprise that additional barriers exist.
Now at least, the Legislature and the next governor know what those barriers are, and what they have to do to get past them.
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