A healthy smile is something that is often taken for granted. For many of the Island’s children, however, access to oral health is neither a reality nor a possibility. Mount Desert Island Hospital’s dental center project came about as a solution to this ongoing problem. Once completed, the Southwest Harbor Dental Center will be the first in the area to fully operate as a non-profit, designed to offer solutions and access to care to island families and residents.
Physicians at MDI Hospital and Health Centers regularly see a range of problems associated with poor dental care, from disease and pain to personal and social limitations caused by tooth decay. Often, patients visit the Hospital for emergency treatment for dental issues that could have been avoided through proper dental care. “One of the major shortcomings of practicing in Maine has been the lack of access to dental services. Most of the babies I delivered started out healthy. Due to a combination of factors—including poor nutritional choices and lack of preventive dental care—cavities are one of the most common problems I see. Poor oral health is so preventable, yet treatment is so expensive,” says Julian Kuffler, MD, MPH.
Dr. Kuffler, MPH has been a driving force behind the Southwest Harbor Dental Center and is a champion of the Hospital’s medical home approach, which started at the Community Health Center and has since spread to three additional health centers in the Hospital system. Under the medical home model, a team of providers work together to offer patients coordinated, comprehensive health care. By integrating dental health care with primary health care, hospital providers have a better chance of preventing and treating dental disease, improving chronic disease management and identifying disease precursors, says Dr. Kuffler, MPH.
Lack of access to dental care is a continuing public health issue throughout the state. Hancock County has been deemed underserved for dentistry, with one dentist per 2,177 people. With a population of over 54,000, there are only 25 dentists in the region, three of which are on MDI. This is significantly below the national average. To compound the problem, the tradition of care regardless of a patient’s ability to pay that exists in medicine is rare in private practice dentistry. MaineCare, Maine’s version of Medicaid, covers basic dental care for children in its program up to age 21; however, only a few of the 25 dentists in Hancock County provide care—most on a limited basis—to MaineCare patients.
To date, the Hospital has raised $800,000 of the $1.2 million needed to implement the Southwest Harbor Dental Center. The home adjacent to the Community Health Center has been purchased to house the new clinic and renovations and site work have begun. The center’s business plan, based on the Pew Charitable Trusts Children’s Dental Health Initiative, projects that our oral health care program will break even in two years.
The initiative provides a business model in which a dental hygienist functions as a dental care manager, coordinating with primary care providers, OB providers, community care team, day care centers and schools to ensure that island childrens’ oral health needs are being addressed from birth through high school.
“Patient Centered Medical Homes are demonstrating improved delivery, coordination, quality and health outcomes as well as bending the cost curve. It is time to transfer these skills learned in primary care and develop a patient centered dental home that fully integrates with our larger patient centered medical community,” says Dr. Kuffler, MPH.