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Maine law allows unsupervised dental hygiene practice

Augusta, Maine—In July, Maine will become the second state in the nation to allow the unsupervised practice of dental hygiene.

The bill, LD 2277, passed both houses and was signed by the governor April 15.

Currently, Colorado is the only state with unlimited unsupervised dental hygiene practice. Another 18 states allow hygienists to practice with limited supervision, though state laws restrict the setting, the hygiene services or the duration of time over which hygiene care may be provided.

John Bastey, the Maine Dental Association's director of governmental affairs, said the outcome is one of several unfavorable proposals referred last year to the state's Department of Professional and Financial Regulation for sunrise review.

Three other approaches to addressing access needs were proposed in the most recent session.

"Creation of a separate licensing board for denturists and hygienists was a nonstarter for MDA, as were the concepts of licensing graduates from non-CODA accredited dental schools and an advanced practice dental hygienist who could perform restorative care and extractions," said Mr. Bastey.

"The MDA executive board thoroughly discussed the idea of independent hygiene practice," said Mr. Bastey. "It was obvious that the legislature was determined to act on the access issue, so the board decided they would not oppose it since it seemed to be the least-worst option."

An MDA-proposed amendment to the bill requiring independent practicing hygienists to have collaborative agreements with a dentist was not approved.

However, MDA was successful in its opposition to another aspect of the bill. After LD 2277 was written, the state's denturists submitted an amendment calling for a separate subcommittee that would have enabled denturists to write their own rules separate from the state's board of dental examiners.

"That changed the Maine Dental Association's position to 'against,' " said Mr. Bastey. "We lobbied hard against that portion of the bill and were successful." 

The MDA achieved a significant victory in this past legislative session through passage of an MDA-originated bill to give new dentists to the state a $15,000 tax credit for five years starting Jan. 1, 2009. The pilot program of two years' duration will be limited to five dentists each year and the dentists will have to practice in underserved areas.

"After the pilot runs its course, a report to the taxation committee will guide what happens next," said Mr. Bastey. "If it is successful, as we think it will be, we will ask for a larger number of dentists to be covered. Our original bill was much larger in scope, but in a very tight budget year we were pleased to get anything through the legislature that had a cost attached to it. Ours was one of only a few that made it through."

The MDA was also able to exempt amalgam from inclusion in a child safety bill and support a provision that allows retired military dentists to reduce their tax burden by taking a credit against their military retirement pensions, said Mr. Bastey.

The ADA is supporting the Maine Dental Association advocacy efforts through its State Public Affairs program.