Dental clinic goes Miles for Smiles Mobile unit targets low-income kids

BANGOR – Children in northern and eastern Maine will have something new to grin about when the Miles for Smiles mobile dental clinic hits the road in September.

Officials from the state Bureau of Health, Anthem Blue Cross and Blue Shield and the Penobscot Community Health Center announced Monday the collaboration that will make it possible to deliver oral and dental care to thousands of low-income children in Maine’s most underserved areas.

The 42-foot Miles for Smiles clinic will look like a colorful recreational vehicle, but inside it will house three modern, fully equipped treatment areas.

Children will benefit from preventive treatments such as cleanings, fluoride applications, sealants and X-rays. They’ll have cavities filled as needed and also may undergo minor surgical procedures such as extractions and root canal surgery.

Like any dental office, the clinic will keep track of children’s dental records, make medical and orthodontic referrals as needed and provide education to patients and their families.

The purchase and outfitting of the clinic on wheels carries a price tag of between $450,000 and $500,000 according to Jim Parker, general manager of Anthem. The insurance company is picking up the tab.

Miles for Smiles will operate as an outreach program of the stationary dental clinic at Penobscot Community Health Center, a federally subsidized doctors’ and dentists’ office in Bangor. Dentists, hygienists and dental assistants from the health center’s dental clinic will staff the mobile unit.

The dental clinic at PCHC opened just seven months ago and serves about 3,100 adults and children from the area. An upcoming expansion will double its capacity and allow access to a waiting list of about 3,600 more.

The mobile unit is expected to provide care to more than 5,000 children under 18 years old with family incomes below 200 percent of the federal poverty limit – about $36,000 for a family of four.

Kevin Kelley, chief operations officer at PCHC, said the mobile clinic has the capacity to provide 3,600 dentist visits per year and about the same number of cleanings by hygienists.

Miles for Smiles will travel the back roads of Aroostook, northern Penobscot, Piscataquis, Somerset and Washington counties, setting up at schools, churches, civic clubs, Indian reservations – wherever a community wants to gather its eligible children.

Maine’s low-income residents have poor access to dental care, in part because Medicaid reimbursement rates are so low that many dentists won’t accept patients. As a Federally Qualified Health Center, PCHC receives somewhat higher payments.

Additionally, the number of practicing dentists in Maine is lower than the national average, especially in rural areas. On top of that, pediatric dentistry is a specialty area that many dentists won’t undertake.

Dr. Frederick Herrick, who recently retired from his dental practice in Greenville, said Monday that there are only five dentists practicing in all of Piscataquis County, an area the size of the state of Connecticut. Patients often must travel long distances to a dental office. An appointment often means a day out of school for kids and time lost from work for parents. Elderly patients also are reluctant to travel the long distances, Herrick said.

Bureau of Health director Dr. Dora Mills described the mobile unit as “a kind of immunization project” because it will protect the state’s highest-risk children from developing cavities and other problems. “Poor oral health stays with children for a lifetime,” affecting their overall health, their nutrition, their ability to communicate effectively, their self-esteem and their employability, Mills said.

She praised the Miles for Smiles project as an example of the kind of public-private collaboration needed to solve Maine’s health care problems. “It will take initiatives like this to augment the governor’s [health care reform] plan,” Mills said.

According to Mary Jude of the Maine Dental Access Coalition, dental disease in Maine is five times more common than asthma, and 35 percent of adults over 65 have no teeth of their own. Getting children into care is the most pressing need, she said, but in time the Maine Dental Access Coalition hopes to expand services to low-income adults and seniors as well.