As a father of eight children, I know firsthand the importance of dental care for children. Seeing kids go without care convinced me to support the creation of a new dental school here in Maine when I was in the Legislature. At the time, we said over and over again, “The dental school is part of the solution, not a panacea.”
When York County’s own Speaker of the House Mark Eves sponsored LD 1230 to establish a dental hygiene therapist, I was thrilled to know that another piece of the dental puzzle would be in place. This legislation is straight forward:
Establish a mid-level provider similar to a physician’s assistant in medicine who would work under the supervision of a dentist. Have identical training to a dentist for the routine procedures they perform, and have a dental hygiene degree so they can teach prevention.
Dentists who don’t like the idea are not required to hire a dental therapist. That’s the free market. And, dentists who do want to hire a DHT can further limit the employee’s scope of practice if they want.
The best news is that, just like physician’s assistants and nurse practitioners, DHTs are proven to work. In Minnesota, Alaska and the more than 50 countries that have them, access has increased, patients have gotten quality care, and here is the kicker: Dentists actually make more money. If you don’t trust me, check out the more than 1,100 papers written about this since it first arrived on the scene more than 90 years ago, at media.khi.org/news/documents/2012/04/10/Nash_Dental_Therapist_Literature_Review.pdf.
What makes the most sense to me is that in Minnesota, some of the DHTs get in a van and go to schools throughout the state. When they are there, they do dental cleanings, just like in Maine. But, when they find a cavity, they can take a picture of it, send it to the supervising dentist, agree on a treatment plan, and place the filling in the diseased tooth.
In Maine, when a hygienist sees a cavity, 75 percent of those kids never get to the dentist. If we had DHTs in Maine, they could provide that care on site with the approval of the parent and the supervising dentist. And, because they are all hygienists before they get the additional training, they can do all the work on prevention to make sure the child develops good oral health habits. What could make more sense?
So, here’s the rub: Common sense rarely has a place in political debate. Even though Maine dentists bitterly complain about low reimbursement rates and no-shows, and have demonstrated their inability to serve low-income kids, it seems they don’t want anyone else to care for those kids either. Turf, not common sense, seems to pervade this debate.
Maine’s dental lobby is using its substantial political power to stifle innovation in the dental marketplace. While this fight has gone on over the last three years, the number of MaineCare kids without a dentist has grown to 110,000, 33 percent of Maine third-graders continue to have untreated dental disease, Maine’s dentists remain second oldest in the nation and 40 percent of them plan to retire or reduce their hours within the next five years, and fewer than 12 percent of Maine dental practices are accepting new MaineCare patients.
Some of the very same dentists who fought against the dental school years ago, thinking it might create more competition, are now saying it’s the only solution to all our problems. Like we said then, it’s only one part. And sadly, while the dental lobby has been fighting against increased dental access and changing their minds about the dental school, Maine kids have been suffering.
Interestingly, Maine dentists rightly brag about our high marks for the application of dental sealants. But, what they fail to mention is that typically dental sealants are applied by dental hygienists in school-based programs ”“ and rarely by a dentist. So, if we are doing so well using mid-level providers for dental sealants, it would stand to reason that DHTs can help fill the gap in care for kids needlessly suffering with dental pain.
The good news is that LD 1230 is a common sense solution that is proven to work for people with no dental care. I hope you will join me on calling on our local legislators to support LD 1230. If you need more information, visit www.dentalaccessforme.com.
— Gary Connor is a former Democratic state representative from Kennebunk.
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