Dealing with a dental dilemma Maine sinks teeth into recruiting effort

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AUGUSTA – Bearing coolers full of lobster rolls, Maine dentists visited New England’s dental schools hoping to lure students into setting up practices in Maine.

And just days ago, the governor announced that Maine and a Canadian university had agreed on a partnership aimed at encouraging more students from the state to go to dental school.

A move is on to draw more young dentists to Maine, where the ratio of dentists to residents is well below the national average.

While officials say they can show no statistical link between the dental health of Mainers and the number of practicing dentists, figures leave little doubt that Maine lags behind the rest of the nation in several measures.

According to the latest figures by the state Department of Human Services, there were 584 dentists actively practicing in Maine in 1998. That breaks down to one dentist for every 2,127 residents, far worse than the national figure of one dentist per 1,743 residents. The national ratio reflects 1996 figures, the most current available.

American Dental Association data place Maine among the dozen states, along with the District of Columbia, with the smallest dentist-to-resident ratios in the country.

Other New England states also have few dentists. New Hampshire and Rhode Island each have 0.4 dentists per 1,000 residents. Vermont has 0.2, Connecticut 1.2 and Massachusetts 2.3.

Other trends suggest the ratio is not likely to improve soon in Maine. Between 1994 and 1998, the number of dentists reporting active practices increased only by 11, according to the DHS.

And between 1982 and 1998, the percentage of Maine dentists ages 35 and younger shrank from 23.5 percent to 6.9 percent. Other figures show a growing percentage of dentists at the 45-and-older end of the scale.

Amid the graying of Maine’s dentists, the Maine Oral Health Program reports that 2.6 percent of Mainers 25 to 34 years old and 14.6 percent of those in the 35-to-44 age group had lost six or more teeth because of tooth decay or gum disease. The figures, from 1995, are the latest available.

A DHS report to the Legislature said Maine ranks among the top five states whose 65-and-older population has experienced total tooth loss.

Figures are not yet available that might link the low ratio of dentists to poor dental health, said Judith Feinstein of the Oral Health Program.

However, a U.S. Surgeon General’s report published in 2000 said Maine residents experience “inequities and disparities” in access to oral health care.

“In Maine, these disparities are related to socioeconomic factors and supply of licensed dental professionals and are compounded by our geography and population distribution,” the report says.

In practical terms, Maine is a rural state, and dentists tend to locate in affluent, urban areas, Feinstein noted.

Factors outside of Maine also have an impact on the availability of dental services in the state. Several dental schools around the country have closed because of financial problems, said Frances Miliano, executive director of the Maine Dental Association.

Another factor is cost. Students attending public dental schools can count on debts of $75,000 to $100,000 when they graduate, and those attending private schools can tally up loans amounting to $150,000, Miliano said.

“And then there’s the cost of setting up a practice and buying equipment,” she added.

Action has been taken on several fronts to bolster the number of dentists in Maine.

Last Monday, Gov. Angus King announced a partnership with Dalhousie University under which the Halifax, Nova Scotia, school will set aside spaces for as many as six students from Maine each year who qualify for its two programs in dentistry.

The Canadian school benefits from the partnership by attracting students who might not otherwise have heard about its dentistry programs, King said.

For students, the cost of attending dental school could be cut by a third, thanks to a favorable U.S.-Canadian exchange rate, Miliano said.

The MDA is also going all out to attract students in American dental schools, in some cases using Maine’s most famous delicacy as bait.

It has sent recruitment teams to each of the four New England dental schools bearing coolers of lobster rolls along with information packets extolling the positive points of living and working in Maine.

Last spring, luncheon meetings were set up at Tufts, Harvard, Boston University and the University of Connecticut dental schools where MDA representatives distributed information about licensing, quality of life, cultural amenities and local dental contacts. Similar gatherings are planned for this spring.

Information packets also have been mailed to every other dental school in the United States and Canada.

“The dentists found there were many misconceptions about Maine,” said Miliano. Some students believed the state is devoid of arts and culture, and that they would not be able to practice modern, high-tech dentistry.

The MDA also is undertaking a “career awareness” effort in which dental and hygienists’ careers will be promoted at high school and college career fairs. Some promoting may also be done in the middle schools, Miliano said.

Regional list of dentist-resident ratios

Statewide, Maine has one dentist for every 2,127 residents, which breaks down to roughly 0.5 dentists per 1,000 people.

Using American Dental Association figures, here is a ranking of New England states for the number of dentists per 1,000 residents:

. Massachusetts: 2.3 per 1,000.

. Connecticut: 1.2 per 1,000.

. Maine: 0.5 per 1,000.

. New Hampshire: 0.4 per 1,000.

. Rhode Island: 0.4 per 1,000.

. Vermont: 0.2 per 1,000.