Access to dental care in Maine reaching a crisis point

University of New England students Sarah Hall, left, and Rianna Sweeney treat 5-year-old Lorena Steinbeck of Westbrook at the Opportunity Alliance's Children's Free Dental Clinic. Derek Davis/Staff Photographer

Dulceneia Standback moved to Westbrook from Boston about a year ago, and since then she has been unable to make dental appointments for her five children.

So when Steinbeck, 39, heard Thursday about a free dental hygiene clinic in Portland, she took her two young children, Lorena, 5, and Maya, 4, to get checked out.

At the clinic, Standback also connected with Mainely Teeth Dental Clinic so her family (who use MaineCare for dental insurance) can receive regular checkups and care in the future.

“I'm so grateful. It's a weight off my shoulders. Finding a dentist is very difficult. We tried everywhere, but the waiting list was so big we couldn't get in,” Steinbeck said. She said that while she prefers Maine as a place to live than Boston, it's easier to schedule a dental appointment in Boston.

Dulceneia Standback, 39, of Westbrook holds her daughter Maya, 4, while University of New England student Rhianna Sweeney Opportunity Alliance's free dental clinic treated her teeth. Derek Davis/Staff Photographer

Experts say Standback's experience is similar to that of many in Maine, where a workforce shortage coupled with increased demand has led to a lack of available appointments, regardless of what type of insurance a patient has.

Theresa Cahill, executive director of the Maine Dental Association, said the lack of access to dental care in Maine has reached crisis point.

“It's a perfect storm. It's a very, very difficult time right now,” Cahill said.

Lorena and Maya took their hygiene appointments in stride, enjoying the attention and pretending to brush their teeth on a giant plastic model of their mouth.

“I love the dentist. The dentist cleans my teeth,” Lorena said.

University of New England student Lily Benner holds a model of the mouth of 5-year-old Lorena Standback of Westbrook while she practices brushing her teeth at the Opportunity Alliance's free dental clinic. Derek Davis/Staff Photographer

The dental hygiene program is a partnership between the University of New England, Opportunity Alliance, Mainely Teeth, Northeast Delta Dental Insurance and UCLA.

Opportunity Alliance connects families participating in the Women, Infants, and Children Program (a federal nutrition program) with a free dental care program, a new service that operates out of the Portland office approximately 40 weeks per year. It has treated more than 100 people so far, mostly children.

UNE will then connect patients to Mainely Teeth, a Portland-based mobile dental care program that also has two building locations and accepts MaineCare patients.

Garrett Richardson, a clinical assistant professor of dental hygiene at the University of New England, said if there are no openings at Mainely Teeth, they will connect families with other dentists who accept MaineCare.

Richardson said there are many barriers to accessing dental care, including labor shortages and Maine Medical reimbursement rates have improved but are still lower than private insurance. Some people also have difficulty navigating the system and finding a dentist who can see patients, which can be especially challenging for those with language barriers, such as new Mainers who immigrated from other countries.

Manna Dzhuleba of Auburn sits with her 9-year-old son, Andrew, at a free children's dental clinic hosted by the New England University and Opportunity Alliance. Last August, the family fled the war in Ukraine and came to Maine. Derek Davis/Staff Photographer

On Thursday, Richardson and a group of University of New England dental hygiene students worked with the Dzhulebas, a Ukrainian family who fled and resettled in Auburn after the Russian invasion in August 2023.

Richardson used a translation service to communicate with Manna Dzhuleba, who spoke only a few words in English and came to the clinic to care for her son, Andrew. Richardson provided Andrew with special fluoride treatments and referred him to a dentist at Mainely Teeth to treat suspected cavities.

He said another Ukrainian-speaking translator will help families make appointments.

Recognizing access issues, the Mills administration is increasing reimbursement rates by 8.24% in 2023 for many Maine health care services, including dental care.

State health officials also are “concerned about access to care due to a lack of dental providers and specialists,” said Lindsay Hammes, spokesperson for the Maine Department of Health and Human Services. MaineCare is in dialogue with dental providers and community outreach groups to explore additional strategies to encourage more dental providers to participate (MaineCare).

The Mills administration has also launched several initiatives to try to increase the dental workforce, including a program to help graduates of dental programs and other health fields obtain student loans, Harms said.

Education systems, including the University of New England, have also been working to increase the dental nursing workforce. Starting in 2027, UNE will add eight new dental graduates each year, increasing the number of graduates from 64 to 72.

Manna Dzhuleba of Auburn and her 9-year-old son Andrew sit at a free children's dental clinic hosted by the University of New England (UNE) and Opportunity Alliance. Derek Davis/Staff Photographer

However, surging demand and challenges finding workers have made access to dental care difficult, said Cahill of the Maine Dental Association.

“In the wake of the pandemic, finding dental care for those who don’t already have access to a dental office is a challenge,” Cahill said. “This isn’t just a problem for Maine Medicare patients. It’s a problem for many people. is an issue regardless of whether they have commercial insurance, self-pay insurance, or Maine Medicare. The dental field's workforce has been extremely tight since offices reopened in 2020 in Maine and across the country.

Cahill said while the increase in Maine's Medicare reimbursement rates is appreciated, it doesn't change the labor shortage and private insurance reimbursement rates have stagnated.

The number of dentists in Maine has declined since 2019, even as demand and the state's population have increased, and the state added adult dental benefits under MaineCare in 2022, bringing an additional 200,000 Adults are eligible for dental care.

According to the U.S. Bureau of Labor Statistics, the number of dentists in Maine dropped from 590 in 2019 to 530 in 2023.

University of New England professor Garrett Richardson spoke with Auburn University's Manna Dzhuleba Thursday at a free children's dental clinic, with the help of a far-flung interpreter. On the right is Dzhuleba's 9-year-old son Andrew, who is practicing brushing a model's teeth with UNE student Rhianna Sweeney. Derek Davis/Staff Photographer

Cahill said 57 percent of Maine's dentists are 60 and older, and not enough new dental graduates are licensed or practicing in Maine because many go to work in other states.

“We have dentists across the state doing their own hygiene because they can't hire hygienists,” Cahill said.

Cahill said the crisis will lead to a major legislative measure in 2025 (the details of which have yet to be determined) aimed at increasing the dental workforce and alleviating serious access problems.

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