Dental care is an essential investment for Maine

By Sue Mackey Andrews

Although Mainers take pride in the many ways in which we serve as a positive role model for the rest of the nation, oral health is one area where we have been failing our children.  

Maine ranks third to last in the nation in the percentage of children insured by Medicaid who receive any preventive dental care. Even among children who have commercial dental benefits, too many go without care. 

There are many reasons for this long-standing problem. Maine suffers from a shortage of dentists, and in some areas of the state, it can take several hours to travel to a dental office if parents can afford the service, have the transportation needed, and actually can get time off work to take their child. This visit is usually “out of our county” and can consume a whole day — meaning missed school and missed work.

Tooth pain can an incredible painful experience for children and can disrupt their education and the simple things in life — like eating. When children have poor dentition, cavities or prematurely lost teeth, their self-esteem struggles. This scenario can unfortunately extend into adulthood and negatively affect a person’s ability to get a job due to poor dentition. 

Dental disease is largely preventable when children have access to early prevention and treatment. However, in our Maine Highlands region, where more than half of our children under age 12 are enrolled in MaineCare — the state’s Medicaid program — we have only one dentist who accepts MaineCare.  

Dental disease plagues so many people in Maine that it appears we have forgotten it is a disease we know how to prevent and treat. Brushing, flossing and good nutrition habits are certainly an important part of oral health care, but making sure children can get preventive services like fluoride varnish and sealants also has a major impact. Unfortunately, for too many families, securing time off from work, finding a dentist to see their children, physically getting there and being able to afford the fees are all barriers that prevent children from getting this essential health care. 

One important solution is the Maine Center for Disease Control and Prevention’s School Oral Health Program, which brings oral health screenings, fluoride varnish and sealants right to students where they already are: in school. Many adults today remember the glory days of this program when kids lined up for the pink plaque-disclosing tablets and fluoride “swish.” Pretty simple, right? And effective, too.

Unfortunately, cuts over the decades have eliminated all of the state oral health staff positions, and the school program currently serves only about a third of elementary schools in the state.

This year, our Legislature has the opportunity to reverse this downward trend. LD 1501, An Act to Protect Oral Health for Children in Maine, would expand the School Oral Health Program so that all schools can participate. The bill would also restore one state oral health coordinator position at the Maine CDC to ensure the program’s effectiveness and data-driven approach, as well as to address workforce shortages and provide public health leadership on oral health issues for all ages in Maine.  

Exploring ways to make preventive dental care more accessible is good for the economy as well as good for our health. Every state general fund dollar spent on Medicaid dental services brings in nearly twice as much in federal matching funds. The restoration of a state oral health coordinator is imperative to make Maine competitive in applying for available federal oral health funding that we have been leaving on the table.  

When we sacrifice our children’s oral health to save a few pennies, we pay a much worse price; and we pay it over and over again. There are many challenges facing the Legislature this session, but this is a winnable battle, and the time to act is now. Oral health is health, and our children need this to succeed in life.

Mackey Andrews of Dover-Foxcroft is a volunteer with Helping Hands with Heart and the Maine Highlands Working Communities Challenge.