Saturday, December 7, 2013
I have an independent dental hygiene practice in Bridgton. I mostly see MaineCare kids and adults who do not have dental insurance or who have trouble affording care.
I refer patients to the only remaining local dentist, and he refers patients to me. I work with other dentists who are 11/2 hours away, but theses offices have restrictions for appointments and some of the dentists will retire soon, and there aren't any to replace them.
If the Legislature passes L.D. 1230 to create a dental hygiene therapy degree, I could do more. I would add more school visits, reaching underserved kids. If I'm at the local school doing a cleaning and find a cavity, I could treat it under the supervision of a dentist. For more complex cases, I'd refer them to a dentist.
Mainers, especially those in rural areas and low-income folks, need better access to dental care. I see it every day.
That's why I was so disappointed in a recent column by Dr. Jonathan Shenkin that focuses on dental care in New Zealand, but not on solutions that address Maine's needs.
A series of studies, one of the most comprehensive state oral health assessments in the United States, thanks to the Maine Legislature and funding by the Maine Dental Association, American Dental Association and others, found that:
* 65 percent of kids on MaineCare can't get dental care, making Maine sixth-worst in the nation.
* 40 percent of Maine dentists are going to retire or substantially reduce hours in the next decade.
* 15 of the state's 16 counties have federally designated dentist shortage areas.
* Many Maine dentists don't see many MaineCare patients, and many who do aren't taking additional MaineCare patients.
* Providers with expanded training and duties have increased access to preventive dental care to rural Maine and low-income individuals.
* Dental hygiene therapy is an effective strategy to get dental care to the one in five Mainers left out currently.
Considering the fact that Dr. Shenkin's own organization funded this study, I was shocked by how little he talks about it. Then, however, I did some digging. Shenkin was appointed a national representative for the Chicago-based ADA, a trade group that has been fighting ideas such as L.D. 1230 for more than a decade. He is also past president of the MDA, which said in its June 2012 Newsletter:
"How would Maine look to you if you were starting a practice and dealing with denturists, Public Health Hygienists, Independent Practice Dental Hygienists (taking x-rays), Dental Therapists and Advanced Dental Hygiene Practitioners? All promising to care for Maine's poor but all competing for those patients who can pay. ... Let's do what we can to maintain 'dentistry as we know it' for the young dentists and students looking forward to the same great career."
I don't know the motivations of Shenkin or the Maine Dental Association in opposing L.D. 1230 -- a bill that is much closer to what Minnesota is doing than New Zealand -- but a lot of great dentists care about underserved people in our state.
I just want everyone to focus on what is need in Maine, not an island near Australia. More than 30 Maine organizations support L.D. 1230 and only one -- the Maine Dental Association -- opposes it.
If this bill passes, I along with others can become a dental hygiene therapist and help serve Mainers who do not receive dental care. We could make it easier for parents to get care for their kids, with fewer problems about taking time off work. We also could reduce skipped appointments because we'd bring care closer to patients.
Shenkin's focus on dental care in a far-off island might be interesting to some, but in Bridgton we're focused on the dental crisis here in Maine. With 65 percent of our MaineCare kids without a dental home, lowering barriers to care with L.D. 1230 just makes sense.
Cathy Kasprak is a dental hygienist who runs an independent dental hygiene practice in Bridgton. Cathy is also the president of the Maine Dental Hygiene Association.