Movement toward enabling dental therapists gets boost in Maine

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

The battle over mid-level dental providers has come to Maine and reporters at the Portland Press Herald have been closely covering it.

A bill that would allow dental therapists to practice in the state advanced in the legislature on March 6 but will require additional votes in the house and senate before it reaches the desk of the governor, staff writer Steve Mistler reported.

The legislation had been amended from a previous version to tighten dentists’ supervisory roll over the auxiliaries.

“The amendment, designed to gain the support of Gov. Paul LePage, strengthens portions of the bill to ensure that therapists are directly supervised by licensed dentists,” Mistler explained to readers.

 “The original version of the bill required dentists to oversee the work of therapists, but the amendment requires that applicants acquire written permission from a licensed dentist and that the dentist has to be participate in the patient diagnosis before the therapist can perform a procedure.”

As proposed, dental therapists in Maine would be allowed to fill cavities, but not perform root canals, Mistler reported.

“They would receive a minimum of four years of training and as many as six years. They also would need 1,000 hours of clinical training with a licensed dentist before becoming certified,” he wrote. “The new position’s status in relation to a dentist would be similar to the one between a nurse-practitioner and a doctor.”

Supporters of the model, including state Rep. Heather Sirocki, who is a co-sponsor of the bill and a dental hygienist, say that dental therapists would help expand care to under-served communities, Press Herald staff writer Joe Lawlor reported last month.

“If you go into the outer reaches of Maine, there is a problem with access,” he quoted Sirocki as saying. Proponents also say the therapists would increase access to dental care in nursing homes and schools.

But as in Minnesota and Alaska, where therapists are already working, dental organizations have been fighting the model.

“The Maine Dental Association disputes that there’s an access problem – 97 percent of the state is within 15 miles of a dentist, the association contends,” Lawlor wrote.

In Lawlor’s story, which was accompanied by an interactive locator map showing the state’s dentists, Jonathan Shenkin, D.D.S., M.P.H., an Augusta pediatric dentist, pointed to an increase in practicing dentists in the state in recent years and a low rate of untreated tooth decay among the state’s third graders.

“Why are we calling this a crisis in Maine?” Shenkin said. “Maine does an excellent job of getting people the treatment they need.”

1 thought on “Movement toward enabling dental therapists gets boost in Maine

  1. Linda Loranger

    Access to dental care in Maine is severely hampered by the fact that most dentists will not practice in remote areas and even in areas that have plenty of dentists, 80 percent will not accept Medicaid. Requiring that a dentist approve all procedures by a mid-level dental provider beforehand will do nothing to help expand access to those who need it most. Who is Maine trying to help? Residents or an established profession?

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