As an oral and maxillofacial surgeon, I treat patients in the hospital and private practice. I’m seeing a concerning trend of patients, covered by MaineCare, who cannot find a dental provider. Often, their only recourse is multiple trips to an emergency department before treatment requires an operating room.

Initially, there was fanfare that more people would be covered by MaineCare but it seems that few offices accept MaineCare, leaving patients with nowhere to go other than the ER.

Running a dental practice is like running any business. The overhead ranges from about 50 to 70%. This overhead covers all the costs associated with a modern practice. Unfortunately, MaineCare reimburses 40% of what it costs to provide the care for a patient. No business can stay open if it costs money to have patrons come in. I am at a loss of why our legislators don’t see the simple math of running a business and extending this to MaineCare reimbursement for dental care.

If the state were to increase MaineCare reimbursement more providers might sign on to help see these patients in need. The cost of one extraction is much more cost-efficient than three ER visits, an ambulance ride, an ICU stay or an operating room needed to drain an infection. The current reimbursement model for MaineCare favors emergency care more than preventative and restorative care.

This is the equivalent of covering finger amputations instead of providing care for the simple finger infection when it was easier and more cost-effective to treat.

Killian D. MacCarthy, DMD, MD, FACS
Board-certified oral and maxillofacial surgeon
South Portland