The Challenge
Maine faces ongoing challenges in children’s oral health. Tooth decay – also called dental disease – causes cavities and affects more children than allergies or asthma, yet it receives far less public attention. By third grade, nearly 45% of Maine children have experienced dental disease. Access to care has become more difficult since the pandemic, and Maine no longer has a data system to track dental disease in children. These issues are rooted in long-standing systemic factors and require coordinated efforts across health care and public health systems to fix them.
Dental disease is the most common chronic disease of childhood, yet oral health is frequently siloed from primary care. Children cannot prevent cavities with brushing and flossing alone — professional care is essential — but too many Maine children go without regular dental care.
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The traditional dental care system in the U.S. relies heavily on private practices, limiting access for people with public insurance or no insurance. These gaps contribute to disparities in preventive care and oral health outcomes across Maine, and are not solved easily due to our small population and large rural geography.
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- expanding access with new care and payment models
- redesigning the system
Structural factors, including poverty, discrimination, and historical inequities mean certain populations face greater barriers to care. People with public insurance or no insurance are more likely to be low-income, identify as a person of color, or have other social vulnerabilities. Without targeted interventions, these disparities will persist.
More resources: See our Equity and Data pages for profiles and source materials.
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Dental care has typically been delivered in episodic, in-office visits rather than ongoing management. New approaches and technologies, such as silver diamine fluoride (SDF) and glass ionomer, allow for chronic management of chronic dental disease by delivering care earlier and more often in schools, primary care, and other community settings where people already spend time. Current systems, however, do not consistently support these models.
Learn about how COHN partners are developing tools for treating dental disease as a chronic condition
There are not enough dentists and dental hygienists to meet statewide needs, especially for community-based and minimally invasive care. Expanding and diversifying the workforce is critical to improving access, equity, and quality of care.
Learn about how COHN partners are expanding and diversifying the oral health workforce
State agencies, like the Maine Centers for Disease Control & Prevention and the Office of MaineCare Services, have very few permanent staff dedicated to oral health. This makes it harder to implement systemic solutions, monitor outcomes, and coordinate care across Maine’s communities.
Learn about how COHN partners are advocating for more public oral health policies and resources