Maine struggles with such a lack of dentists that some doctors adapt to heal themselves.
Most children in Maine do not receive annual checking and cleaning from a dentist. Even dental insurance does not guarantee access: only a Third of children with any kind of insurance Take both checking and cleaning each year, according to a study last year by the University of Southern Maine Muskie School of Public Service and Catherine E. Cutler Institute.
The most commonly proposed solutions are to train more dentists and increase Minecare rates to make dentists more affordable to receive lower income patients, said Becca Matusovich, executive director of the Maine’s Oral Health Network.
Indeed, dentist classes are decreasing, From 590 in 2019 to 530 in 2023. The Maine’s Children’s Oral Health Network is a defense coalition that focuses on improving the prevention, education and treatment tools for children’s oral health.
However, Matusovich said possible solutions should not be limited to adding more dentists and increasing compensation.
“We are so far away from the scale that we need that they just train that more dentists will not bring us where we should be,” he said.
In response, its organization works to extend access to oral health treatment beyond the dentist’s office. These early intervention options can stop worsening the cavities and help relieve the delay for dentists, letting them focus on more advanced treatment, Matusovich said.
An example is a treatment called fluoride of diamine silverwhich more pediatricians in Maine have begun to use in recent months as training programs have increased. Dentists have used treatment much more.
World Health Organization in 2021 added treatment to it Model list of basic drugsand the American Academy of Pediatrics has Guidance issued in its use in the medical environment. The solution is a mixture of silver and fluoride.
Dr. Brian Youth, a pediatrician at Mainehealth and president of the Maine of the American Academy of Pediatrics, was one of the first in the state to incorporate the treatment with diamine fluorine in primary care practice, first in the Pediatric Housing Clinic in Maine Medical Center and Maine Maine Maine.
Most pediatricians are already offering fluoride varnish during good child visits as a preventive measure, the youth said. Now, when it finds a cavity, it can provide fluoride silver diamonds to substantially dismiss decomposition and kill bacteria.
Youth said it is a pretty easy process. First dries the tooth. It then uses a applicator that looks like a Q-Tip to press the treatment in decomposition for 30 to 60 seconds. He then follows the family to another appointment four to six weeks later to see if they need a second application and check if they can see a dentist for further evaluation.
“Pediatricians have so much on their plate that they have to cover with families on different visits and some may see this as an additional project that pediatricians undertake because patients cannot receive the dental care they need,” the youth said. “But I would say this is important because of the morbidity associated with dentalist [decay] to our patients. ”
The cavities and tooth decay can cause infection, be painful for children and could make them less likely to attend school, the youth added.
Since he began to provide the treatment of silver diamine fluoride last autumn, the youth and his colleague Dr. Laura Blaisdell treated more than 70 patients at the Maine Medical Center. They have also taught pediatric residents in education for the application of silver diamine fluoride.
Matusovich, with Maine’s children’s oral health network, said some possible disadvantages The treatment may be that it can stain D he added that it is not recommended if the cavity is too long.
More pediatricians could soon participate in the youth. In recent months, the child -funded child -funded child -funded health -based health care network in the Maine Fluoride Silver Diamine From the first toothincluding a recent County in Washington. And a pilot program that has completed this summer trains six school nurses and a Maine school center to identify early signs of decomposition and apply fluoride silver diamine.
Fluorine of silver diamonds is one of the many ongoing solutions, Matusovich said. Another program, which has been tested with head start, had dental cleaning and early interventions in the school environment and then uses telemedicine visits for dentists to remotely revise X -rays and other documents.
The pilot ended last year, but Matusovich said the initial participants were continuing the program and her organization received additional funds to extend to new communities.
And a bill introduced the last session, Ld 1746It would require the Ministry of Health and Human Services of Maine to develop a model for additional preventive health and oral health interventions and to provide at least one dental service provider in each public health region. It would also require DHHS to train primary care providers in minimal invasive treatments for children.
This bill has been transferred and will be examined at the upcoming session.
“Prevention is the key to sure, but what these new tools and new strategies give us is the ability to stop the cavities very quickly,” Matusovich said. “There is this step between the point where we now have fluoride of silver diamine and other minimal invasive care options that may be much more available outside the dental office.”
Correction: This story has been informed to clarify that Dr. Brian Youth started for the first time the treatment with silver diamine at the Pediatric Residency Clinic at the Maine Medical Center.
