3 min read

A Maine child eligible for dental treatment via Medicaid should be able to access it within days, if needed, not made to wait in pain for weeks — or months.

Last week, we published a report detailing the particular challenge families on MaineCare face in getting dental surgery for their children. 

The Maine Dental Association, which has characterized this specific problem as “acute,” estimates that thousands of kids across our state, in need of dental intervention that requires anesthesia, are stuck on long waiting lists each year.

Michael Dowling, a pediatric dentist based in Yarmouth, said under the existing rates of reimbursement by the Maine Department of Health and Human Services, willing dentists can lose up to $400 for every hour that a child is placed under general anesthetic.

The result? More and more clinics aren’t in a position to take these young patients on.

“It’s terrible to have to tell parents this,” said Whitney Wignall, a Portland pediatric dentist, speaking about her own nine-month waiting list. “You feel horrible as a person. You have children with an infection and know they have to wait while they have this infection in their mouth. It’s not a safe nor a good or ethical way to practice.”

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If the way out of this failure seems simple, know that it is. The Department of Health and Human Services must adjust the rate for this work, for these patients. 

Responding to a reporter, a spokesperson said the DHHS was aware of the problem. Indeed, the department has agreed to tweak its rate reassessment schedule; pulling a five-year process forward by one year such that it can take place next year. 

For a child in discomfort, whose teeth may be deteriorating by the week, that’s just not soon enough. 

It’s important to note that what’s at issue here isn’t always a major dental surgery; whereas an older child generally doesn’t need to be anesthetized for fillings or other common work, a younger child might. 

Online last week, one of our readers paused to take stock of the oral health problem as a whole. “We need a multi-pronged solution, starting with early childhood education about dental care, school programs to promote healthy nutrition and dental care and sustainable reimbursement rates for dentists,” they wrote. 

“If you’re aware of tuition rates for dentists, you may also realize we need scholarship programs to bring more dental students and practitioners to Maine.”

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All of this is undoubtedly true. While our recent reporting — and this editorial — zeroes in on the treatment of children, the financial shortfall is entrenched and unsparing.

“I am at a loss of why our legislators don’t see the simple math of running a business and extending this to MaineCare reimbursement for dental care,” South Portland dentist Killian D. MacCarthy wrote in a sharp letter to the editor in January of this year. 

MacCarthy, referring to all patients, reported a “concerning trend of patients, covered by MaineCare, who cannot find a dental provider. Often, their only recourse is multiple trips to an emergency department before treatment requires an operating room.” 

He continued: “This is the equivalent of covering finger amputations instead of providing care for the simple finger infection when it was easier and more cost-effective to treat.”

The onus is on the state of Maine to keep up its side of the bargain so that deserving children in need of dental care — so that all patients in need of care — can be taken out of their misery. The various economic headwinds and labor market challenges of 2025 are not trivial, but a deal is a deal. 

Correcting these circumstances will have an immediate benefit for the patients in question and, due to the value of preventative care (refer to the professional amputation analogy above), a long-term benefit for the patients in question — and thus for the families and, in the end, for the state itself.

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