Lawmakers are considering two bills that attempt to increase access to dental care in Maine by studying ways to establish specialist residency programs in the state and creating a new license tier with lower educational requirements, a measure that multiple dentists opposed.

L.D. 2206 would establish an associate dentist license, which would allow a dentist without the equivalent of a U.S. doctoral degree in dentistry — such as a dentist with a bachelor’s degree who trained outside of the U.S. — to practice dentistry under supervision of a licensed dentist. 

Under this new license, associate dentists would have a pathway to full licensure if they were in good standing for six consecutive years. There is currently a pathway for foreign-trained dentists to work in Maine, but it requires additional education.

The bill comes as access to Maine dentists has declined. The ranks of dentists decreased from 590 in 2019 to 530 in 2023. Most children in Maine don’t get an annual checkup and cleaning from a dentist, according to a study last year from the University of Southern Maine Muskie School of Public Service and Catherine E. Cutler Institute.

Penobscot Community Health Care, Maine’s largest federally qualified health center, brought the issue to lawmakers after two “very highly qualified” dentists the center hoped to hire were denied licensure by the Maine Board of Dental Practice because they didn’t meet current educational equivalency requirements.

The health center estimated those dentists could have provided 8,000 appointments with patients, according to testimony from Lori Dwyer, president and CEO of Penobscot Community Health Care.

Penobscot Community Health Care, which said it operates the largest dental center in Maine and has a network of 51 workspaces for dental care, emphasized that federally qualified health centers are subject to strict federal oversight, reporting requirements and high standards.

“[Penobscot Community Health Care] would never support a pathway that compromises safety, and they would never hire a clinician that would provide unsafe treatment to patients,” Dwyer wrote in testimony that was read on her behalf to the Legislature’s Health Coverage, Insurance and Financial Services committee.

Northern Light Health also submitted testimony in support, saying the bill would help address workforce shortages and reduce emergency room visits for dental conditions.

“Like most hospitals in Maine, Northern Light Health members are challenged with inappropriate utilization of our emergency rooms by individuals seeking care for dental/tooth pain,” Lisa Harvey-McPherson, vice president of government relations, wrote in her testimony. “Patients generally present with cracked teeth, abscesses, dental caries or tooth eruptions, leading to thousands of emergency room claims for dental related diagnosis codes each year.”

Multiple dentists and dentistry representatives testified against the bill, arguing that there are existing pathways for foreign-trained dentists and that lower standards could set up a two-tiered system in which poorer and more rural residents receive care from dentists with less training.

Dr. Kailee Jorgenson, a licensed dentist who is the clinical director at Portland-based Mainely Teeth and president of the Maine Oral Health Centers Alliance, said the patients most likely to receive care under the proposed pathway are MaineCare recipients, rural residents and children. These patients often have the most complex needs, she said.

“Maine should not create one standard of dentistry for those with resources and another for those without,” Jorgenson told the committee.

Jorgenson and others who testified against the measure said they instead support a second bill, L.D. 2209, which would study how to expand access to dental care.

L.D. 2209 would direct the Maine Department of Health and Human Services to consider how to establish dental specialist residency programs in Maine, including for pediatric dentists, oral surgeons and orthodontists. The bill would also require the department to study ways to create a hub-and-spoke model to expand access to services across the state.

“We have a shortage of specialists in Maine, and it doesn’t matter how you’re trying to pay,” said Therese Cahill, executive director of the Maine Dental Association, which represents dentists. “To see an oral surgeon, to see a periodontist, to see an orthodontist, or a pediatric dentist, you’re waiting.”

No one spoke against the bill or submitted testimony in opposition.

The committee will consider both bills during upcoming work sessions when it will decide whether to forward them to the full Legislature. The work sessions had not been scheduled as of Wednesday.

This story was originally published by The Maine Monitor, a nonprofit civic news organization. To get regular coverage from The Monitor, sign up for a free Monitor newsletter here.