Dental safety net

In 2002, with good oral health care, 95 percent of oral disease is preventable. With preventive oral health services twice a year, with fluoride treatments and oral health education the pain of decaying teeth is a thing of the past for 74 percent of Maine’s children.

Unfortunately for many low-income children in Maine with Medicaid this is not the case. These children with Medicaid insurance make up about 26 percent of the children in Maine and they have 85 percent of all children’s dental decay. Children from low-income families are disproportionately affected and are affected at an early age. Cavity rates among children age three to five attending Head Start Preschool and Childcare programs range from 16 to 65 percent. Cavity rates of 35 to 68 percent are reported for children under the age of three enrolled in the WIC Program.

Maine must respond to the rampant oral disease, which has reached crisis proportions in most children with Medicaid insurance. Maine must use direct intervention to increase the number of dental providers accepting Medicaid insurance. An increase in the Medicaid reimbursement rate, as proposed by LD 477 is, at the present time, the only means at hand that will prevent the collapse of Maine’s children’s dental Medicaid services.

Less than 1 out of 10 dental providers are accepting new Medicaid children into their practices and those that do take only one or two at a time. The dental safety net for our low-income children is coming apart because the Medicaid reimbursement for oral health services is so low that providers cannot meet basic overhead costs. This offers no alternative to most private providers other than to decide not to participate in the Medicaid program. The substandard Medicaid reimbursement rates severely impacts non-profit dental centers and programs too, because Medicaid fees constitute a major part of their income. Without increased reimbursement rates thousands more Medicaid children will suffer painful and disfiguring oral decay as well as poor nutrition and missed school days.

To increase the participation of Maine dental providers and to keep our nonprofit dental clinics and programs operating, a much-needed realistic increase in Medicaid reimbursement rates for dental procedures is needed. Without a rate increase, private practice dentist’s participation in the Maine Medicaid Program will continue to dwindle and Maine’s dental safety net of nonprofit clinics and dental centers will continue to unravel and fail.

The Maine Dental Access Coalition believes a rate increase will allow private dentists and community dental centers to assure that all Maine’s children have the same low rate of oral disease. LD 477 provides a much-needed increase in Medicaid reimbursement rates for dental procedures. LD 477 was passed by both houses of the Legislature and currently is waiting for funding from the Appropriation Committee.

LD 477 is not a dentist’s bill, it’s a bill for all the low-income children in Maine who go to bed each night in pain, it’s for the children that can’t eat because their teeth hurt, it’s for the parents who can no longer cope with their child constantly being in pain and crying and its for the very youngest, so they won’t suffer like their older brothers and sisters may have. Without a realistic increase in Medicaid reimbursement rates for dental procedures we are condemning thousands of Maine’s most vulnerable children to continue to live in pain.

Jack Fuller is chairperson of the Maine Dental Access Coalition.