Monday, March 10, 2014
AUGUSTA – Dentists came to the State House in droves Thursday to oppose a bill that supporters say will help expand access to dental care in the state, particularly in rural areas.
House Speaker Mark Eves, D-North Berwick, is sponsoring L.D. 1230, which would create a new category of dental professionals called dental hygiene therapists.
They would have the ability to pull teeth, place crowns, administer anesthesia and prescribe anti-inflammatories and other drugs in consultation with a supervising dentist.
"Too many Maine kids are not getting dental care," Eves said. "The legislation before us is a critical strategy to meet a pressing need."
Yet many dentists -- the Maine Dental Association estimated that 100 dentists came to the Capitol -- told the Legislature's Labor, Commerce, Research and Economic Development Committee that the bill is unnecessary and gives too much responsibility to those with far less training than dentists.
"We care about the quality of dental care in Maine," said Dr. Robert Berube of Manchester. "We have the capacity. We have the work force. The answer is getting them to these providers."
Eves lined up multiple and bipartisan co-sponsors for his bill and got support on Thursday from the Roman Catholic Diocese of Portland, Maine Children's Alliance and the Maine Association of School Nurses.
Supporters said children learn from a young age not to smile if they are embarrassed about their teeth.
"The discomfort and self-consciousness of oral health disease interferes with children's ability to learn, and dental pain leads to missed school," said Janice Hogan, legislative chairwoman for the school nurses association.
Eves and other supporters cited statistics from a December 2012 study conducted by the Center for Health Workforce Studies at the University of New York in Albany. A bill passed by the previous Legislature called for the study so lawmakers could work from a set of facts while creating new policy, Eves said.
The study found that while two-thirds of Maine's population lives in a rural area, only 13.5 percent of dentists practice in those areas. Also, within the next five years, 24 percent of Maine dentists plan to retire and an additional 16 percent expect to reduce their hours, according to the report.
Eves said more than 55 percent of children on MaineCare did not see a dentist in 2009, and in that same year, there were 11,960 separate dental-related MaineCare emergency room visits that cost a total of $6.6 million.
Sen. Andre Cushing, R-Hampden, asked whether Eves would consider a pilot program in parts of the state, rather than a statewide solution.
"What I wouldn't want to do is continue to nibble around it," Eves said. "The data came back, and it demonstrates a clear need."
The dentists say they have developed an emergency room diversion program that works and will be expanded.
They say they donate their services to the poor and that more young dentists are in school and will be ready to join the work force soon.
"Should we be fragmenting our system?" asked Dr. Demi Kouzounas of Saco.
"The poor seeing a provider with a bachelor's, while those who can, see a dentist? I would like to ask this committee, is this the right approach?"
The committee expects to consider the bill in a work session in the coming weeks.
Susan Cover can be contacted at 621-5643 or at: