Inside Maine's mouth

The state's decaying dental health
By DEIRDRE FULTON  |  May 3, 2012


Last summer, 29-year-old "Jane," who lives in Portland, had a serious problem involving an "old root canal gone wrong." She was developing an abscess in her gum; it was oozing . . . well, it wasn't pretty. "I didn't have dental insurance at the time so I was smashing up old antibiotic pills and shoving them in the hole in my gum," she recalls. "Eventually the gum receded . . . leaving this giant filling, no tooth, and a loose gum around it." Finally, Jane went to a dentist, who told her she would need to cough up $2500 to fix things up. The financial burden was difficult, but considering that dental abscesses can have catastrophic effects on one's general health, there wasn't any other option than to find the cash.

Unfortunately, stories like Jane's are all too common here in Maine. If you live in a rural part of the state, don't have private health insurance or are low-income, have children, or are a senior citizen, there's a good chance you find it difficult, if not impossible, to find a dentist or pay for dental care. And the consequences are worse than a messed-up smile or even a painful cavity. Ignoring oral care as a key component of our general health — and health-care policy — drains our economy and places us at risk for serious medical complications.

As a first step in addressing these woes, the state legislature commissioned a study in 2011 to assess Maine's oral health care needs. Completed by the Center for Health Workforce Studies at the State University of New York in Albany earlier this year, the findings are a comprehensive picture of the dental-health landscape in Maine. The X-ray shows serious decay, big cavities, and the need for some serious filling, plus maybe some reconstructive surgery.

• Maine has FEWER DENTISTS PER CAPITA than in most other states, including the rest of New England. Whereas the national average is 6 active dentists per 10,000 people; in Maine the average is 5 per 10,000. In Oxford, Somerset, and Waldo counties, that number dips below 3. Fifteen of the state's 16 counties have federally designated "dental health professional shortage areas," which means that there aren't enough dentists to serve the population's dental needs — ranging from routine cleanings to specialty oral surgery.

• In 2010, Maine ranked 34TH OUT OF 50 STATES in terms of the percentage of residents who had seen a dental provider in the past year (just under 69 percent).

• In Maine, dental complaints were the number one reason for EMERGENCY ROOM VISITS among MaineCare patients and uninsured people between the ages of 15 and 44 in 2006, the most recent year for which comprehensive statistics are available. Regardless of the reason, this is clear indicator that people aren't getting the dental care they need. According to "A Costly Dental Destination," a study released this February by the Pew Center on the States, "hospital treatment for dental problems is nearly 10 times more expensive than preventative care" (all those MaineCare visits cost more than $6.5 million) — not to mention the fact that ER treatment is just a Band-Aid. "Patients are often treated in emergency rooms with painkillers and antibiotics, but the underlying root of the problem, sometimes serious dental disease, may not be treated," said MaineHealth executive vice president Frank McGinty in a Lewiston Sun Journal opinion column last month.

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