Dr. Meghann Dombroski of Community Dentistry, rightly, sees Ryleigh Hansen of Auburn for orthodontic care. Contribute / community dental
York’s Owen Greek travels with Devon Bergeron’s guardian for an hour in Portland for dental care every few weeks in Community dentistry, the only clinic receiving Minecare within a Portland radius. Contribute / community dental
Owen Greek, 14 years old, had straps for two and a half years.
Every sixth Thursday during these years, his grandmother, Devon Bergeron, leads him to Community Dentistry in Portland where they live in York. It takes an hour both ways, and Owen often loses a whole day of school. Open only on Thursday and operates by Dr. Meghann Dombroski, is one of the only offices in the area that Mainecare receives – Maine’s Medicaid program – for orthodontics.
“Unfortunately, with Minecare, where we live in York-and they consider it such a high quality area-there are no dentists where they get Minecare,” said Bergeron, who is also the Guardian of Greek.
The experience of Greek and Bergeron is not uncommon in Maine. The orthodontic clinics that accept Minecare are few and far away in Maine, with Community dentistry or only in the radius of Portland. Minecare clinics often have long waiting lists or do not accept new patients.
Community It is a non -profit oral health care program with locations also in Biddeford, Lewiston and Farmington. While all sites accept Minecare and offer other payment options for low -income patients, Portland has the only orthodontic unit, which accepts exclusively Minecare patients.
GREENE was first connected to Community dentistry through Biddeford’s office for general dentistry. When it was time to get any braces, he referred to the Portland site. It is not uncommon for patients and their families to travel to Community dentistry for Portland Orthodontics for hours. The cost of travel and lost work are also burdens that can prevent care.
The Community Dental Orthodontic Group provides medically essential orthodontic care to adolescents aged 10-21 years. Orthodontic care is not cosmetic, but for oral function and health as it is considered by Minecare. For children who do not receive the care they need, the results can overcome oral health. Chronic pain, speech obstacles and social spots can remain well in adulthood, affecting both their personal and professional lives.
“There is a need and it matters, and these kids deserve it,” Dombroski said.
“I really love the idea of helping people, but also to do so in the kind of public health system we are here because I want to leave these obstacles,” Dombroski said.
On Thursday, Dombroski leaves its private orthodontic practice in Falmouth and treats about 50 patients in Community dentistry with three staff. While now they only undertake four general dentistry chairs for the day, next month, the construction is scheduled to turn a office space into a new orthodontic suite, allowing them to face more children and hope to hire a complete timely orthodontist and expand. Currently, waiting alone for a new patient to receive a consultation is seven months.
“I also hope that the (the new office) has the ability to be able to be a similar crown jewelry of this place,” said Dombroski, who founded the program in 2018 and hopes to see it grow and maintain itself.
With Master’s in Public Heath in addition to her doctorate, Dombroski saw the need to extend access to Orthodontics in the wider Portland area and took things into her hands.
“(The New Clinic) will really show good public health planning, but also a good integration of public health … How everything works together in a system.”
Community dentistry has found their solution to the provision of orthodontics for children in Minecare, a puzzle that remains for providers and patients in Maine in general.
Straightens the financial
At Dental’s orthodontic clinic, 13 -year -old Abdirazaq Ahmed took equipped with an expander, a metal device on the roof of his mouth that will make room for his teeth later transfer straight straps. His three older brothers received all the braces through Community dentistry, a medical necessity that would be banned by the cost if not covered by Minecare, his father, Abdi Ahmed, said.
“Without it, it would be really detrimental,” said Ahmed, who lives with his family at Westbrook.
In 2022, Orthodontics coverage for teenagers were expanded on the basis of evidence This orthodontic treatment is an effective approach to alleviating serious oral health problems later in life. In the same year, Minecare also expanded to dental coverage for adults.
However, Minecare’s compensation for orthodontic procedures limit the clinics that Mainecare can accept, as the rate of compensation is two -thirds or smaller than the cost of straps in a traditional orthodontic office. In the practice of Dombroski in Falmouth, MBRACE Orthodontics, straps cost between $ 5,000 and $ 7,000 for equipment, staff and overviews. For braces at Community Dental, Minecare returns $ 3,172. This difference means that many orthodontic practices cannot accept patients with Mainecare and be sustainable and those who should be creative.
Some clinics make Minecare accepted through grants or through charities or additives to existing dental clinics. Other orthodontic practices receive a limited number of Minecare patients and take them with several patients with service. In Community dentistry, the only integration into an already functional, low -income dental office holds them alive.
“Part of the reason that happens to work here at this clinic is because we could incorporate this orthodontic clinic into a fully functional, existing clinic,” Dombroski said.
“It would be extremely challenging and I almost want to say impossible, for an orthodontic practice to see exclusively Minecare (patients) without funding or using other resources that this clinic already has,” he said.
A pressure on the wider health care
The limited number of orthodontists accepting Maineecare exerts pressure on other aspects of health care as well. The Mainehealth Lip and Palate Clinic at the Barbara Bush Children’s Hospital in Portland faces children born with upper lip tissue and the roof of the oral underdeveloped, of which about 20 are born in Maine each year. Many children with the condition should receive a bone graft between ages 8 and 10 to complete their gumline. To be possible, they must take orthodontic work between 6 and 8 years.
Without an orthodontist in the Mainehealth system, the clinic of slit and palate should refer patients to external providers. Amanda Payne, a nurse and coordinator of the clinic, said they are in Minecare over half of their patients.
“So there is only a small handful of orthodontists that we can refer to these patients, many are not geographically accessible to families and this makes things really difficult for many families,” Payne said.
Finding an orthodontist who receives Minecare patients is a point of stress not only for parents but also for providers.
“Whenever it is time to refer to a child in an orthodontist, I immediately feel the stress of myself to find an orthodontist who has availability to see the children and this is quite accessible to families to make it work,” Payne said.
More generally, pediatric oral health care generally in Maine faces challenges. When a child does not receive regular dental care, not only can this cause unprocessed cavities and decomposition, but is not able to refer to orthodontics at the right time. This can cause dental issues later, which are more painful, intensive and expensive.
In Cumberland County, in 2022, there were 94 clinics or offices for restorative and preventive dental care and Only six of these practices They reported the acceptance of new pediatric patients with Minecare insurance. Since June 2024, 16,593 children at Cumberland County who had Minecare did not receive the minimum of two exams and/or cleaning in the last 12 months, According to dental measurements Minecare.
“It’s not as if we can respond to the need with a few points here and there. As if everyone just gets two more … we are so far away from being able to respond to the scale of the number of children who need service,” said Becca Matusovich, the executive director of the Network.
Comparing the states, Maine took 20th place for children who had one or more preventive dental visits over the past 12 months, with 81% estimation over two years, according to America’s health rankings. This is around the national average, but the lowest in New England.
Matusovich and other leaders of dental care in the state systematically think about how to provide more dental and orthodontic care to children in Maine. This includes integration into school clinicsThe fight against the lack of dentists and orthodontists who come and work in the state and work to extend the coverage and integration of Minecare into the providers system.
“We really need to think about how to create solutions to the scale we need,” Matusovich said.
Making a permanent impact
At the Dental Orthodontic Clinic, their work changes the effects of oral health, smiles and prosperity of life. For some patients, orthodontic treatment is not only healthcare, but the confirmation of a larger system that matters, Dombroski said. The whole orthodontic staff had stories to watch children’s confidence to improve during their care.
“Imagine you are taking your braces away. And someone was this cheerlead for you for two years is like” that is such a great day! “You will never forget it for the rest of your life.
As for Greek, he looks forward to revealing his new smile in his second year of high school, as his straps are scheduled to come out this summer. Around the same time, his grandmother will begin to take his younger sister to begin orthodontic treatment in Community dentistry.
“My road trips will continue,” Bergeron said.
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