For all the talk about health-care reform during the last few months, little has been said about oral health. This is not new, as dental care is often ignored, both by policymakers and the general public. But it has quietly become one of the nation’s, and Maine’s, most urgent and costly health needs.
According to the Maine Center for Disease Control, tooth decay is the most chronic disease among children, five times more prevalent than asthma. As with other chronic diseases, people with tooth decay who lack the resources for preventative care often end up in the emergency room, receiving high-cost care that should be done instead in a dentist’s office.
Dental problems can also contribute to and exacerbate other conditions, such as heart problems, diabetes and poor nutrition. The costs to the health-care system are enormous, and the patient suffers far more than needed.
While too many Mainers – around 180,000 – lack health insurance, many more do not have dental insurance, and even those with some level of coverage cannot find a dentist to treat them. Residents on MaineCare are often turned away by dentists unwilling or unable to accept the state’s low reimbursement rates for dental work, which also act to discourage dentists from setting up shop in Maine.
The access problem was on full display last Friday when 13 area dental offices, including some in Gorham, Scarborough, South Portland and Buxton, came together to offer cleanings, fillings and extractions at no cost to Mainers without insurance. Lines formed early at each of the sites, and by the end of the day the group, calling themselves Dentists Who Care for Me, estimated that they served around 700 people.
Many of the recommendations from a 2007 state task force convened to combat these problems – increasing reimbursement rates, incentives for treating MaineCare patients, loan repayments for dental students – are likely untenable for now due to the massive state budget shortfall, even though long-term savings would be realized.
But some of the state-level recommendations could still move forward now, even in this economic environment.
One is the integration of oral health care into overall health care, by encouraging hospitals and dental providers to work together to recognize and deal with a patient’s dental problems as soon as possible, so that costly urgent care is not needed.
Education should also continue with the public so that people, especially adults, understand the importance of dental care, and what can happen if tooth decay goes untreated. While schoolchildren receive adequate education on dental care, they seem to forget it by the time they are adults. Most people would not shrug off chest pains; the same level of concern should be held for toothaches.
Finally, it falls on many of the providers to find ways to treat the underserved population. Mobile units that visit schools, especially in rural areas, are a wonderful way to reach patients. For preventative services, clinics such as those run by the University of New England at its Westbrook College campus also work well, as does Community Dental in Portland, whose services are provided on a sliding-fee schedule.
But until more comprehensive changes can be made, we urge more such free clinics like the ones Friday by Dentists Who Care for Me. Right now, they are the best bet for better dental health.
Ben Bragdon is the managing editor of Current Publishing. He can be reached at bbragdon@keepmecurrent.com, or followed on Twitter, @benbragdon.
Send questions/comments to the editors.
