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Western Maryland’s recovering addicts receive dental care

November 01, 2019

By David Burger

 western maryland


Frostburg, Md. — Dr. Jordan Hobel recalled that when he returned from his Baltimore dental school to his hometown of Frostburg in western Maryland to practice dentistry, his friends had needle marks in their arms.

The quiet, safe neighborhoods where he used to ride bikes as a child were not the same.

The house he grew up in had changed the most, he said.

It had turned into a drug house.

The opioid epidemic in his region, at the foot of the Appalachian Mountains, has since remained so devastating that he estimates that half of his patients are in the midst of, or have struggled with, addiction.

Even within Dr. Hobel’s office, the epidemic hits particularly close to home. One of his dental assistant’s nephews died from an overdose last year, he said.

 Dr. Romaine
Dr. Romaine

So when Dr. Hobel heard that Maryland Area Health Education Center West — best known around his parts as AHEC West — was launching a dental access project specifically targeting recovering addicts, he jumped at the chance to participate.

“I said, ‘We have to do this,’” Dr. Hobel said.

With a two-year, $100,000 grant from the Maryland Community Health Resources Commission, AHEC West’s project seeks to expand existing oral health care services by enlisting partner agencies and providers to treat patients who are in recovery from opioid and other addictions such as methamphetamine and are in need of dental treatment.

Only addicts who have been clean for nine or more months will be eligible for the program, said Susan Stewart, AHEC West executive director.

“Those in recovery face myriad obstacles in their quest to beat addiction, with lack of regular dental care and poor oral health a common affliction that can add significantly to the many challenges they face,” Ms. Stewart said. “Regional economic conditions, health care limitations and impacts from the opioid crisis also contribute to the challenges those in recovery face in obtaining adequate dental care.”

Dr. Diane D. Romaine, past president of the Maryland State Dental Association and current president of the Maryland State Dental Association Foundation, practices in Frostburg and plans on providing dental care to recovering addicts.

As a member of AHEC West’s board of directors, Dr. Romaine said the board of the local community-based organization recognized that the western Maryland counties of Allegany, Garrett and Washington had become an epicenter for addiction in the state.

They knew they had to do something, considering that in 2016, Allegany County was second only to Baltimore in the number of heroin-rated deaths per capita, Ms. Stewart said.

“Many residents of western Maryland simply cannot afford to pay to see a dentist,” Ms. Stewart said. “In addition, all of Garrett County and parts of Allegany and Washington counties are designated by the federal government as Health Professional Shortage Areas for Dental Care, essentially meaning there are too few dentists to meet population needs. The heroin and opioid epidemic has also hit the region especially hard, creating a large and vulnerable population of those who are addicted or in recovery, and in need of dental care.”

Dr. Romaine is not blind to the epidemic that endangers the health of many Frostburg residents.

“People addicted give up on themselves,” Dr. Romaine said. “You see a lack of ability to take care of themselves.”

The priority of people with additions, she said, places the need for a fix over taking care of their teeth — and thus their overall health. That, coupled with the destructive effects of drugs on their oral cavities, leads to rampant periodontal disease and dental decay, she said.

Besides Drs. Hobel and Romaine and other area dentists, the Allegany County Health Department will also participate, providing both patient referrals and health services through its dental services program. The dental program director, Dr. Gretchen Seibert, said the nascent program initiated by AHEC West was a natural fit for the health department, which sees patients at all stages of the addiction cycle, including many sent there by a nearby emergency room.

“People in recovery often have complex and urgent needs,” Dr. Seibert said. She considers her team’s commitment to the recovery program as integral to who they are as oral care providers. “In my heart, [all our patients] are my extended family. That’s our role, to help anyone that needs help and can’t find it.”

Utilization of a community health worker, working closely with the AHEC West case manager, is central to the program. They are trusted health care workers who share similar backgrounds to the people they serve and through cultural competency can better relate to the challenges they face in maintaining healthy lifestyles, Dr. Romaine said. Serving as a bridge between health care providers and their clients, a community health worker, through home visits, phone contact and other one-on-one interactions, works to positively influence life choices that play a critical role in chronic disease prevention and management, she said.

After intake by the AHEC West case manager, clients will be referred to the community health worker, who will provide education on oral health and proper oral hygiene, helping to prevent future dental problems. Referral to a dentist often follows.

Dental care provided will involve primarily fillings and extractions and may include other procedures, such as dentures or partials, on a limited, case-by-case basis as deemed necessary by a provider participating in the program.

“Oral health problems often involve painful, lingering conditions and addressing these issues, our partners agree, would help those in recovery focus on the many other challenges associated with overcoming addiction,” Ms. Stewart said. “Without this program, most potential participants will simply do without needed dental care, aggravating existing conditions and undermining overall health and threatening their recovery.”

For more information on AHEC West, visit