Maine doctors train to do basic dentistry

FAIRFIELD – Maine has come up with a way to help deal with a shortage of dentists: Family doctors are getting trained on how to pull teeth, lance abscesses and apply fluoride.

Dr. Sarah Spencer, who’s in her third year of residency in Fairfield, is one of those doctors learning basic dentistry. She says it was “pretty intimidating” at first, but she’s getting the hang of it.

“She did 11 teeth on two patients with me looking over her shoulder and she did a good job. And the patients were well-served,” Dr. James Schmidt, president of the Maine Dental Association, said Wednesday.

Dr. William Alto and two other doctors from the Maine Dartmouth Family Medicine Institute, which has offices in Fairfield and Augusta, began building the training program in 2003 because of the shortage of dentists, especially in rural parts of the state.

There are fewer than 600 dentists in Maine, or about one dentist for every 2,200 Mainers, Schmidt said. That compares with the national average of one dentist for every 1,600 people.

There are several reasons for the lack of dentists: MaineCare reimbursements are too low, Maine is a rural state and there’s no dental school in the state, Alto said.

Schmidt, former chief of dental services at the Togus VA Hospital, was enlisted by Alto to join in the program to train family physicians in Dentistry 101.

So far, about 40 family practice residents have gone through the program at the Maine Dartmouth Family Medicine Institute. The goal isn’t to transform them into dentists, but simply to make them aware of oral health issues – without going overboard, Schmidt said.

If they’re comfortable doing so, physicians learn to administer local anesthesia and to remove loose teeth that have single roots, he said. They also can tackle other relatively simple tasks such as lancing an abscess or applying fluoride to children’s teeth, he said.

Expanded access to dental care is important because oral health has been linked to overall health, but not all dentists are thrilled with the new program, Schmidt said.

“It’s not popular among all dentists,” Schmidt said. “My passion is for all of our citizens to have access to good care … I don’t really care who provides the service, as long as the service is appropriate, done well and the follow-up is good.”