For over a year, the pandemic has shown us how public health policies can create a domino effect, affecting families, schools and the entire economy. We have also seen how good public health policy, such as prioritizing the COVID-19 vaccination rollout, has saved lives, gotten people back to work and allowed us to safely hug our loved ones again. But for decades, we have been seeing the negative impacts of an area of public health that has not been prioritized here in Maine, and that’s dental care.

Dr. Douglas Huntley inspects a young patient’s mouth during a routine checkup in Skowhegan in 2017. L.D. 1501 would expand Maine’s School Oral Health Program to serve all schools in the state by 2025, using federal funding to cover the costs of providing preventive dental services in schools. Michael G. Seamans/Morning Sentinel, File

ABOUT THE AUTHORS

Lori K. Gramlich, D-Old Orchard Beach, is a state representative and sponsor of L.D. 1501. As a licensed master social worker, she has worked in public health, including overseeing the Children’s Oral Health Program for the city of Portland. Dr. Steve Mills is a dentist with 40 years of experience, including 34 years specializing in pediatric dentistry in Maine. He is a board member for the Partnership for Children’s Oral Health.

Maine ranks second to last in the nation in the percentage of children insured by Medicaid who receive any preventive dental care. Even among children who have consistent private dental benefits, too many go without care.

There are many reasons for this long-standing problem. Maine suffers from a shortage of dentists. In large areas of the state, it can take several hours to travel to a dental office. In some parts of the state, no dental offices are accepting new patients with MaineCare.

Dental disease plagues so many people in Maine that we sometimes forget it is a disease we know how to prevent and treat. It is caused by a bacterial infection, not by inconsistent dental hygiene habits. Once the disease process starts, you cannot brush your way out of it, and it will eventually affect your overall health and well-being. Brushing and flossing are important tools to prevent the disease, but others, like fluoride varnish and sealants, are available only through a hygienist or dentist.

The Legislature has a terrific opportunity this session to improve oral health in Maine with several important bills. For example, L.D. 996 adds a comprehensive dental benefit to MaineCare for adults, covering the full range of preventive and restorative care that people need to avoid dental emergencies and protect their oral health.

Another critical piece of this policy puzzle is L.D. 1501, An Act To Protect Oral Health for Children in Maine. This bill directs the state to expand its School Oral Health Program to serve all schools in the state by 2025 and to efficiently use federal Medicaid funding to help cover the costs of providing preventive dental services in schools. It would also restore an oral health coordinator position within the Maine Center for Disease Control and Prevention to provide public health leadership to meet our people’s oral health needs.

For many families, insurmountable barriers existed to accessing dental care even before the pandemic, and now those barriers are worse. Many dental offices book checkups six months in advance, and families often don’t have the flexibility to take time off from work for a dental checkup. Reliable transportation can also be a challenge, particularly in rural Maine.

The School Oral Health Program provides a way for the dental profession and our state to actively reach more children. Simply waiting for more patients to show up to dental offices is letting too many kids down. It is time for us to meet them halfway. If we are really serious about solving this problem, we need a viable school program that serves kids where they already are.

The state’s School Oral Health Program has played this role for decades in Maine, but it has been hamstrung by funding and staffing cuts. Currently, only about a third of schools in the state are served. We have the opportunity to expand this program to ensure that no child suffers from preventable dental disease.

When we sacrifice our children’s oral health to save a few pennies, we pay a much worse price, and we pay it over and over again. Just as we are defeating this pandemic with good public policy, we can make oral health care accessible to all Maine families through measures that address the root (canal) of the problem. L.D. 1501 offers a clear path forward.

This is a winnable battle, and the solutions are in the hands of the Legislature this session. Oral health is health, and dental care is health care.