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Action for Dental Health

Maine Dentists Provide Coordinated Oral Health Care for Head Start Students

February 19, 2014

What began with a group of dentists seeking to provide care for Head Start students has expanded into an effort to provide coordinated oral health care for all MaineCare (Medicaid)-eligible children.

When the Dental Home Initiative, part of a national program to find dental homes for Head Start students, was launched a few years ago, Maine orthodontist Dr. Donald Cassidy saw an opportunity to help ensure that more children get the dental services they need.

Working with various Head Start programs and the Maine Dental Association, Dr. Cassidy committed to connecting Head Start children around the state with general dentists.

"I see myself as a facilitator. My part is trying to find dentists able and willing to take new patients who are children. There are dentists who want to help and so many kids in need," said Dr. Cassidy.

By law, Head Start children who are three to five years old must be examined by a dentist within 90 days of enrollment, while children under three must be seen by a dentist or a registered dental hygienist. Each child is then required to have a dental examination once a year.

Despite MaineCare's low reimbursement, which covers only 30 to 40 percent of the cost of the dentists' usual and customary fees, access to care for many of the children is more than a monetary issue.

"It's not unusual to see a 50 percent no-show or cancellation rate. In addition to educating parents, we're working on getting the dentists to the programs. In that way, the dentist can see 20 children instead of 20 sets of parents trying to get their children to the dentist's office," said Dr. Cassidy.

Now, nearly 100 percent of Head Start children in Aroostook County have a dental home.

According to John Bastey, the Maine Dental Association's director of government affairs, the collaboration with Head Start is ongoing.

"Not so long ago there were 95 kids in Kennebec County who didn't have dentists," he said. "Dentists in southern Kennebec County made peer-to-peer phone calls to their colleagues, with the condition that we would work hard so they wouldn't have empty seats."

Other counties soon followed suit, according to Bastey.

"That process worked so well, and the Head Start folks were so eager to get the dentists to help," he said. "We moved on to York County, where 57 of the 325 kids didn't have a dental home."

Dr. Mark Lucier, a pediatric dentist, and his wife, Dr. Megan Lucier, a general practitioner who specializes in working with children, agreed to provide dental homes for all of them, Bastey said.

The Maine Dental Association is now advocating for an expanded pilot program before the Maine Legislature.

State Sen. Eloise Vitelli, D-Sagadahoc, is sponsoring a bill aimed at increasing the number of MaineCare eligible children receiving dental care. The bill requires the Department of Health and Human Services to identify and report quarterly to the Commissioner of Health and Human Services on children birth to 20 who are not receiving dental services, and further directs the department to work with the dental community to establish a pilot program to identify appropriate providers and assist in arranging treatment for children who have not received dental services in the previous year.