Friday, May 15, 2009

Short of Dentists - Maine Decides to Let Physicians Do it

Flap would call this program the instruction in emergency dentistry for physicians - which should be taught in medical schools anyway and ususally is not.
Dentists are in such short supply in that primary care doctors who do their medical residency in the state are learning to lance abscesses, pull teeth and perform other basic dental skills through a program that began in 2005.

“Doctors typically approach the mouth from a distance,” said Dr. William Alto, a physician at the

here in rural Fairfield, which conducts one of two dental clinics for medical residents (the other is at Maine General Hospital in Augusta).

“They say ‘say aah,’ take a look at the back of the throat and are done,” Dr. Alto said. “Many physicians, even family physicians, have given up that part of the body because they don’t have the skills.”

Maine has one dentist for every 2,300 people, compared with one doctor for every 640, and the gap is expected to widen as both dentists and doctors retire over the next decade.

Nationally there is one dentist for every 1,600 people.

Maine has trouble recruiting dentists because many young graduates do not want to work in rural areas. The shortage is much less acute in Portland, the state’s largest city. Maine also does not have a dental school — the closest are in Boston, about 50 miles from the state’s southernmost town.

Last year the American Dental Association and the announced a to train pediatricians to apply fluoride and look for signs of , a step already taken by some other states, including Illinois, Iowa, North Carolina and Washington.

In Maine, training physicians in dentistry provides a dental safety net for the rural poor who have never had one, doctors and dentists said. About two-thirds of the residents who have trained at the dental clinic now practice in the state, many in rural areas.

“I see dental complaints all the time from people who come into the E.R.,” said Dr. Andrew Fletcher, who learned dentistry at Maine Dartmouth during his residency. He now works at Northern Maine Medical Center in Fort Kent, on the Canadian border. “It’s mostly

patients who don’t have money to see dentists.”
Exit question: Is it better to have ER or other primary care MD's treating these patients or mid-level health care dental providers?

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