Maine Legislature approves dental therapist bill

Maine Legislature has approved a midlevel dental therapist bill, which is expected to be signed by Gov. Paul LePage.

The state Senate approved a revised version of the bill April 16 after the concept won approval in the House of Representatives on March 6, according to a pressherald.com story.

The bill, LD 1230, which was amended to gain the support of LePage, strengthens portions of the bill to ensure that therapists are supervised by licensed dentists.

The measure, sponsored by Rep. Mark Eves (D-North Berwick), would allow therapists to work in dental practices in rural areas where dental care is not readily available to many residents, according to supporters of the bill. Some 15 of 16 of the state's counties have a shortage of dentists.

With about 600 practicing dentists, Maine has the fewest dentists per capita in New England. Forty percent of Maine's dentists are nearing retirement, say supporters, which include the Pew Charitable Trusts and the American Dental Hygienists' Association.

The Maine Dental Association (MDA) has lobbied heavily against the bill, arguing that there is no shortage of dentists and the new University of New England College of Dental Medicine will offset future shortages. The college opened last fall.

The proposal is modeled after Minnesota, where 32 dental therapists are now practicing since that state's 2009 law was passed. Midlevel providers (MLPs) are also now working in Alaska, and 15 states are considering licensing them to do similar procedures. Some 53 countries, including Canada, allow dental hygienists to become dental therapists.

A co-sponsor of the bill, Rep. Heather Sirocki (R-Scarborough), said that MLPs will make it easier for people in rural Maine to obtain dental care as some dentists in rural areas are elderly and have limited office hours. Once the bill becomes law, Sirocki said lawmakers will work on expanding what dental therapists are authorized to do in future legislation.

Jonathan Shenkin, DDS, who represented the MDA, said creating a new provider does not address the basic issue -- people aren't accessing dental care because they can't afford it.

Medicaid in Maine does not cover adult dental care, but lawmakers are considering a bill to provide such care, which could reduce emergency room costs for oral care.

Under the Maine bill, dental therapists would work under the direct supervision of a licensed dentist, that is, in the same office as the dentist. The bill requires therapists to have a supervising dentist check their work, such as examining x-rays. Supporters said the measure would allow hygienists to receive additional training to do as many as 53 procedures. Licensed dentists, who receive eight years of training, can perform more than 500 procedures.

The dental therapists would be required to take two years of college-level classes and have 2,000 hours of training with a licensed dentist, and pass an examination by the Maine Board of Dental Examiners. They could then perform prophylaxes, restorations, and extractions but not root canals.

The new position would be similar to nurse practitioners, according to supporters.

Local colleges could start offering dental therapist classes as early as 2015, the bill's supporters said.

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