Maine lawmakers have been told over and over again that the solution to improving access to oral health care is to add new dental providers. They have created independent dental hygienists, public health hygienists and expanded function dental assistants. But no matter how many new categories are created, some people continue to advocate for yet one more.
Unfortunately those pushing for yet one more provider are using old data to bolster their position. That information was presented as facts in the Jan. 11 BDN article about a new dental provider being pushed at the Maine State House.
I am writing to provide current data to set the record straight. Making policy decisions about an issue as important as oral health must be based on facts, not old data or misleading assertions.
The article implied that people can’t receive dental care outside of dental offices. This is not true. Both public health hygienists and independent practice dental hygienists can provide services in alternative settings such as schools, Head Start centers and nursing homes.
Unfortunately, they often do not work in nursing homes because MaineCare doesn’t cover adults and many elderly cannot afford to pay. This points to an obvious and important fact — the Legislature can create as many dental providers as it can imagine but until there is adequate MaineCare funding to cover the cost of providing dental services, many people will go untreated.
Another error in the article is the out-of-date figure citing the number of people living in underserved areas. According to Maine’s Office of Rural Health and Primary Care, the actual number of people living in underserved areas is about half of what was quoted in the article, or 281,725.
It is also misleading to assume people in underserved areas don’t have dental care. What it really means is that people may have to drive longer distances to get care — whether it is medical or dental.
Very rural areas traditionally have problems attracting physicians and dentists. Any proposed alternative dental providers likely wouldn’t be in those areas either. The reason is simple and fundamental; it is difficult to sustain a practice and earn a living where there are few people to treat. This cannot be corrected by creating one more dental provider.
Other old data provided to the reporter are that only 40 percent of children who are eligible for MaineCare-funded dental care are treated. In 2011, the Department of Health and Human Services reported to the Legislature that 52 percent of eligible children are treated — a very positive trend.
The increase in MaineCare-eligible children being served is good news. It shows that more dentists are treating MaineCare patients and the steps we are taking to improve access are working.
One argument being used to push for another new dental provider, which is getting very tiresome to hear, is that 40 percent of Maine’s dentists will retire in the next 10 years, creating a crisis. I know this is a good sound bite when arguing for a new provider but it totally ignores the fact that many new dentists are moving to the state.
The number of new dentists setting up or joining practices in Maine is increasing, so while some dentists retire, other new dentists are adding to the total. There is no looming crisis.
Additionally, Maine’s first dental school will open next year at the University of New England. It is the plan to have dental students working in clinics in our outlying communities and we expect many of those students will stay in Maine after graduation, adding to our dentist numbers.
In its wisdom, the Legislature set up a study last year to look at what it means for Maine to have these new providers. That study has yet to be written and presented to the Legislature. Why would we ignore this study step and jump one more time into the argument that another dental provider is the answer? We’ve tried that — let’s not be fooled into trying it again.
Hopefully policymakers will realize that access to care is not simple. Until we face the complexity of this issue we will continue to throw darts at the target, hoping we get it right.
Dr. Dean Tourigny is president of the Maine Dental Association. He is a practicing general dentist in Biddeford. He can be reached at president@medental.org.
These are the same people who promised you fluoridation would reduce tooth decay and put dentists out of business. Yeah right. As is stated, more dental schools are opening, more dental professionals are being created and dentists are holding our low income Americans hostage until the government gives dentists more money to actually treat poor people’s teeth instead of their water. This despite 67 years of fluoridation reaching virtually 100% of the population via water, food and/or dental prodcts
Dentists received welfare for the rich in the form of government hand-outs to their tuition, dental schools and more. They need to be required to give back and be mandated to actually treat people who need their care the most – not just those with the most money and best insurance – or get out of the way of viable professionals willing to do so.
Dental therapists can drill, fill and pull teeth just as well as dentists can. But they cost less and usually live where they are needed the most. Their costs are lower because only two years of training is required. They have worked for decades in other first world countries very successfully. The first DTs are working in rural Alaska where residents would otherwise pull their own teeth.
Even though no dentist would work or live in this rural Alaskan town, organized dentistry spent over a million dollars trying to stop them, preferring to hang onto their lucrative monopoly even if people have to suffer
Fluoridation gives the illusion that organized dentistry cares about people who aren’t welcomed in their dental chairs Don’t be fooled. The hundreds of millions of dollars wasted on fluoridation could be better used developing dental therapists in Maine.
These are the same people who promised you fluoridation would reduce tooth decay and put dentists out of business. Yeah right. As is stated, more dental schools are opening, more dental professionals are being created and dentists are holding our low income Americans hostage until the government gives dentists more money to actually treat poor people’s teeth instead of their water. This despite 67 years of fluoridation reaching virtually 100% of the population via water, food and/or dental products
Dentists received welfare for the rich in the form of government hand-outs to their tuition, dental schools and more. They need to be required to give back and be mandated to actually treat people who need their care the most – not just those with the most money and best insurance – or get out of the way of viable professionals willing to do so.
Dental therapists can drill, fill and pull teeth just as well as dentists can. But they cost less and usually live where they are needed the most. Their costs are lower because only two years of training is required. They have worked for decades in other first world countries very successfully. The first DTs are working in rural Alaska where residents would otherwise pull their own teeth.
Even though no dentist would work or live in this rural Alaskan town, organized dentistry spent over a million dollars trying to stop them, preferring to hang onto their lucrative monopoly even if people have to suffer
Fluoridation gives the illusion that organized dentistry cares about people who aren’t welcomed in their dental chairs Don’t be fooled. The hundreds of millions of dollars wasted on fluoridation could be better used developing dental therapists in Maine.
Flouride is toxic. Read up on it’s effects and you will learn that it is well known for causing brain dysfunction, and effects critical thinking. In other words it’s in the water to dumb you down so you will not resist. There is flouride toothpaste on the market so why isn’t THAT good enough ? Because you don’t INGEST toothpaste….that’s why.
You don’t seem to have any idea how to approach the problem at all. You have mentioned the lack of the administration’s efforts regarding jobs and I agree with you. You’ve also noted one of the reasons’s why there is a lack of dentist, and commented on the toxic nature of fluoride. But no suggestions?
I think that Bangorian has an idea, I also feel that if the dentist borrowed public money to attain a degree, then if he or she was willing to practice for a number of years in the rural areas, some of the loan debt can be forgiven. But the fact remains the same; it’s costly. Unless you have some sort of insurance that covers this, an adult won’t be getting much dental health care.
Perhaps we can work with the dentist, insurance company’s and employers for a cap on prices, and make it a little easier on the people and the insurance company’s in the rural areas. Isn’t the Dr’s concern in the rural areas numbers?
What we need to do is mandate that dentists who hold a Maine license be required to provide services to a certain number of Mainecare clients (a percentage of their patient load). Problem solved.
Right….and they will just work free I suppose ? All this will do is hasten the departure of the Dentists we still have. This is what they probably will do though because Maine seems to have a knack for chasing business away to other States.
There are no Dentists in Maine because there is no money trickling down to the people. Instead of trying to put band-aids on all of these incidental issues why isn’t that State Gov’t, namely LePage, doing what he promised when he wanted your vote ? JOBS. Where are all the jobs ? We just lost another chance at 300-600 jobs because of the State’s inaction. If I were a Dentist I would move away from Maine to “greener pastures” and most of them have. The only people doing well in Maine are the ones that got their wealth handed down by Mommy and Daddy.
Another white-frocked bandit whining about his turn at the taxpayer mammary.
As much as I disagree with bangorian, I think this may have some future to it. Lawyers have to do probono work, why shouldnt Dentists..?