Home » Blog » Thousands more Mainers now have access to dental care, but can’t find a dentist

Thousands more Mainers now have access to dental care, but can’t find a dentist

With assist from Claire Bartlett, left, Dr. Kailee Williams, proper, treats MaineCare affected person Steve Lockard at Waterville Neighborhood Dental Middle not too long ago. “The demand proper now for dental providers is simply so excessive,” Williams stated. Shawn Patrick Ouellette/Employees Photographer

Steve Lockard received two cavities crammed this summer season. He additionally has new dentures to exchange lacking enamel.

Whereas routine take care of most individuals, it’s the primary non-emergency dental care the 47-year-old home painter has obtained in about 15 years and solely grew to become potential when he grew to become eligible for MaineCare dental protection in July. He needed to journey about an hour from his dwelling in Moscow to the Neighborhood Dental Clinic of Waterville, but it surely was price it.

“Earlier than, I used to be at all times embarrassed to smile, however now I can smile. I simply have that additional confidence now,” Lockard stated.

However Lockard is likely one of the lucky ones, and he is aware of it.

Maine already had too few dentists. And with more than 220,000 people having just become eligible for the MaineCare benefit, demand is hovering.

Jess Falero of Portland is one in all 1000’s of adults who’re eligible for MaineCare dental advantages however can’t discover a dentist. “Both dentists don’t have openings or they don’t settle for MaineCare,” Falero stated. “It has been 100% irritating.” Gregory Rec/Employees Photographer

Jess Falero of Portland is likely one of the 1000’s of people that additionally grew to become eligible for MaineCare advantages however can’t get in to see a dentist.

“Both dentists don’t have openings or they don’t settle for MaineCare,” Falero stated. “It has been 100% irritating.”

Falero is affected by two cracked enamel and a number of cavities. And whereas it’s good that MaineCare has a dental profit, the 25-year-old group activist stated, the continued lack of entry to care will consequence sick for many individuals.

“Democracy is notoriously very sluggish, however the want is notoriously very pressing,” Falero stated.

A part of the reason being that the general provide of dentists, dental hygienists and different employees is stagnant or declining, in line with the Maine Dental Affiliation.

The U.S. Bureau of Labor Statistics exhibits that in 2019 – earlier than the pandemic – Maine had 590 dentists generally follow, declining to 510 in 2021, the newest yr statistics can be found.

One other a part of the issue is that a lot of these dentists don’t settle for MaineCare sufferers as a result of this system’s reimbursement charges are so low.

The state lists about 40 dental practices that settle for MaineCare sufferers, though the Maine Dental Affiliation stated there are doubtless extra practices that may at the least settle for some MaineCare sufferers. Some dentists have a cap on the variety of such sufferers.

In some circumstances, sufferers might must journey hours to succeed in a dentist keen to see a brand new MaineCare affected person.

Reimbursements for MaineCare dental work have improved by about 70% with the grownup dental enlargement, however dentists are nonetheless solely paid about two-thirds of what non-public insurance coverage pays.

It’s not clear how most of the newly eligible sufferers try, and failing, to discover a dentist.

Based mostly on the expertise of different states, about 3o% of the 220,000 newly eligible adults are anticipated to make use of the dental profit and search care. That quantities to about 70,000 extra individuals who may very well be looking for an open dentist’s chair.

The grownup MaineCare profit is “an awesome win for us and an achievement for us and the state of Maine,” stated Melissa Watson, operations director for Neighborhood Dental, which has workplaces in Portland, Biddeford, Farmington and three different areas within the state. Regardless of the same identify, it’s a totally different follow than Waterville’s Neighborhood Dental. “The draw back of it’s there’s no extra suppliers all through the state of Maine.”

Advocates say entry points are actual, however the system must be given time to soak up new sufferers.

“One thing we’ve uncared for for therefore lengthy can’t be fastened in a single day,” stated Kathy Kilrain del Rio, advocacy and program director for Maine Equal Justice, a progressive group that lobbied for years for the regulation. Maine is now one in all 37 states providing the grownup dental profit for Medicaid, known as MaineCare within the state.

Dentists who do see MaineCare sufferers are reporting being bombarded with requires appointments and have to show them down as a result of there’s not sufficient capability.

“The demand proper now for dental providers is simply so excessive,” stated Dr. Kailee Williams, Lockard’s dentist. “It’s irritating for sufferers calling and there’s nowhere to go.”

Williams stated when the profit opened up in July, they had been flooded with new affected person requests, and inside a month needed to cease accepting new sufferers. They may attempt to work some new sufferers in if there’s a cancellation, but it surely’s troublesome and demand is far increased than the slots accessible, Williams stated.

At her follow in Oakland, Dr. Kailee Williams confers with Steve Lockard, 47, a Moscow resident who’s amongst 220,000 MaineCare sufferers who grew to become eligible for dental protection in July. Shawn Patrick Ouellette/Employees Photographer

Lockard stated he was in a position to get care at Neighborhood Dental as a result of he had beforehand obtained emergency care there. Underneath the outdated MaineCare guidelines, these with the insurance coverage might solely get dental care if there was an emergency, equivalent to needing a tooth pulled. Lockard stated he solely has about 1/3 of his pure enamel, and the remaining are dentures, as a result of he went a few years with out dental insurance coverage.

Therese Cahill, govt director of the Maine Dental Affiliation, stated even earlier than including the MaineCare dental profit, provide was not assembly demand. And the pandemic solely led to extra employees shortages and delays in getting care.

“Discovering somebody who’s taking new sufferers is more and more difficult,” Cahill stated. “It’s been a longstanding downside, however the mild has shined fairly brightly on it because the pandemic.”

Cahill stated because the rollout continues, she’s hoping extra dentists will comply with tackle MaineCare sufferers, and that efforts to broaden the workforce, equivalent to graduating college students into dental careers, will speed up.

For now, staffing is a big impediment, stated Kate Hopkins, CEO of Neighborhood Dental. A part of the clinic’s mission is to serve MaineCare sufferers, however Hopkins stated they’ve a 25% emptiness fee amongst dentists and 21% amongst hygienists, leaving them short-staffed whereas demand ramps up.

In actual fact, employees shortages led to an announcement Friday that Neighborhood Dental could be closing two of its areas this November – in Rumford and Monson.

Watson, the chief working officer of Neighborhood Dental, stated that regardless of improved reimbursement charges that had been tied to the dental enlargement – charges elevated to the place now MaineCare reimbursement is 67% of the income practices get from non-public insurance coverage – it’s nonetheless a monetary disincentive to simply accept MaineCare.

“The concept lots of non-public practices would soar on this feels impossible,” Watson stated. “Why would you add a less-paying service, and fairly frankly a complete new method of billing, to your follow?”

Watson stated packages that the state affords on mortgage forgiveness for these with dental careers are useful, however may very well be improved to be extra sturdy to assist spur current graduates to follow in Maine. Williams, as an example, stated she has $500,000 in pupil mortgage debt to repay.

Dr. Kailee Williams treats MaineCare affected person Steve Lockard of Moscow at Waterville Neighborhood Dental Middle. Serving to out, on the suitable, is dental assistant Claire Bartlett. Shawn Patrick Ouellette/Employees Photographer

Jeanne Lambrew, Maine’s well being and human providers commissioner, stated the state of affairs is much like the general MaineCare enlargement in 2019. It’s going to take time to construct out the grownup dental profit, however the items are in place to enhance entry, she stated. A part of it is going to be elevated consciousness and word-of-mouth as extra dentists tackle new MaineCare sufferers and discover that the improved reimbursements could make the numbers work.

“We do suppose extra dental suppliers are concerned about serving MaineCare sufferers. We’re hopeful the mix of expanded entry, the excellent dental profit and better reimbursement charges enhance the variety of dental suppliers in Maine,” Lambrew stated. “It could take a while to get the provision to satisfy the demand.”

Lambrew stated there are a selection of packages in Maine that use federal funding to spice up the well being care workforce, together with within the dental discipline.

The dental profit is anticipated to value the MaineCare program $45 million a yr. Maine is now one in all 37 states that provide adults some type of non-emergency dental protection.

On the College of New England, the one dental faculty in Maine, the variety of dental graduates will enhance from 64 this yr to 74 in fall 2023.

“This may imply extra dental college students treating sufferers throughout rural and underserved areas of northern New England, and in the end, extra licensed dentists in Maine,” stated Nicole Kimmes, interim dean of the UNE Faculty of Dental Medication.

Kimmes stated a mortgage forgiveness program for college students who keep in Maine – sponsored by Delta Dental insurance coverage – and an externship rotation for fourth-year college students that immerses college students “in rural and underserved communities for 10-12 week rotations” are holding some graduates within the state.

Williams, the Waterville dentist, stated the workforce scarcity stemming from the pandemic has set again efforts to broaden capability.

“Throughout COVID-19, we misplaced amenities. We misplaced suppliers,” Williams stated. “Many locations that got here again, got here again at a decrease capability. Some determined to cease practising altogether.”

The 2020 shutdowns meant that every one however probably the most pressing oral care was delayed, so when dental practices reopened, it took many months to meet up with their current sufferers. And now there’s added demand.

Dr. Genko Stanilov, a dentist and dental director for Neighborhood Dental, stated he hopes different dentists will begin accepting at the least some MaineCare sufferers.

“My message is to please give it an opportunity and hopefully they’ll see they’ll implement it of their follow,” Stanilov stated.

Del Rio, the Maine Equal Justice advocate, stated it’s vital to keep in mind that advocates lobbied for a number of years to get the dental profit for adults with MaineCare, and there might be rising pains.

“There are people who find themselves now gaining access to care who couldn’t earlier than,” del Rio stated. “Over time, suppliers will come on board who aren’t there but.”

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