By Amy Harris

Good oral health helps people lead happy, productive, healthy lives. But unfortunately, foreign-born U.S. residents are much more likely than their American-born peers to have dental disease. In fact, according to the American Dental Association, in 2013-2014, over half of immigrants in the U.S. had some dental disease and one out of every three immigrants had dental cavities.

Dental disease is an infection, problem, or pain in the mouth, teeth, or gums that can have serious consequences. This may include missing work days because of severe pain, difficulty speaking because of tooth loss, and heart disease and stroke because of bacteria that untreated infection and gum disease may introduce into the body.
And dental disease is often connected to other kinds of health problems, some of which are prevalent in immigrant communities, such as diabetes. According to BMC Public Health, immigrants are disproportionately impacted by diabetes (as well as other diseases such as hypertension).
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5683-3)


People with diabetes are at higher risk for oral health problems, particularly gum disease, because diabetes can hinder the body’s ability to heal, thereby complicating treatment.

But barriers limit access to dental care for many low-income Mainers. The state does not have enough dentists, and many dentists do not accept MaineCare insurance. Because of these dual problems, getting an appointment for low-cost or free dental services can be difficult. For this reason, be sure to arrive on time and don’t miss a scheduled appointment. Dental services are in such high demand that many dentist offices will not reschedule patients who have missed even just one appointment.

In addition, MaineCare currently only covers preventive dental care, rather than treatment for dental disease, and asylum seekers are not eligible for MaineCare. However, school-based dental health clinics can be the easiest and most affordable way for many immigrant families to get dental care for their children. Many of these clinics are free, though parents must sign permission forms for their children to receive these services.

• What is oral health? Oral health refers to the health and well-being of teeth, gums, and mouth. Good oral health comes from taking steps such as brushing after meals with a toothbrush and using a toothpaste that contains fluoride. Daily flossing also helps keep teeth clean and gums healthy.
• Why does the oral health of some immigrants get worse in the U.S.? Sometimes people who have recently arrived in the United States notice their oral health worsening. Most likely, this is due to adopting a sugary diet, full of processed foods. For good oral health, fruits and vegetables are healthier choices than sugary snacks, and water is a better choice than sodas or juices.
• What is fluoride? Fluoride is a natural mineral that helps strengthen the outer protective coating of teeth. Toothpastes, mouth rinses, and fluoride varnishes all help protect teeth from dental disease. This is true even if someone already has some decay or cavities.
• What are cavities? Cavities are holes that can form in teeth. Frequent snacking and drinking sugary beverages, without brushing the teeth, increases the chances of developing cavities. This is because bacteria from the sugar lives in the mouth and forms cavities. The cavities start small, but get bigger if untreated. Cavities can be painful and lead to tooth loss.
See the American Dental Association website (www.ada.org) for tips and answers to frequent questions.


The good news is that the dental care situation for low-income adult Mainers will greatly improve soon. Beginning July 1, 2022, thanks to a recent decision by the Maine Legislature, more adults with MaineCare will have access to comprehensive dental care coverage. They will be able to schedule cleanings, cavity fillings, and even root canals and other necessary procedures. Becca Matusovich, of the Partnership for Children’s Oral Health said, “This is a huge success, and something advocates have been fighting [to get] for over 30 years!”

Tips for Oral Health

When should I see a dentist?
Dental cleanings and exams are generally recommended every six to 12 months. Without regular dental care, minor problems with teeth and gums can go untreated and become big problems. In addition, a visit to the dentist is suggested for anyone who experiences the following: mild to sharp pain while eating or drinking something sweet, hot, or cold, or when biting down; visible holes or pits in teeth; brown, black, or white staining on any surface of a tooth.

How can I care for my child’s teeth?
● Children with decay in their baby teeth are statistically more likely to have dental problems later in life, so start cleaning baby teeth with a baby toothbrush as soon as they come in. This is true even though children lose their baby teeth as they mature.

● If a baby has a bottle while going to sleep, only fill it with water. The sugar in milk, formula, juices, and soda are likely to cause tooth decay.

● Adults can have germs in their mouths that cause cavities in babies’ teeth, so don’t share spoons, cups, or toothbrushes with a baby.

● A dentist can brush a fluoride varnish on the outside of children’s teeth. This is a clear protective coating that helps prevent cavities.

Find tips on caring for children’s teeth at www.fromthefirsttooth.org

● All children in Maine are eligible for preventive dental care, including regular dental cleanings by a hygienist at a dentist’s office or dental clinic. A hygienist is a specially trained health professional who works with dentists to clean teeth as part of routine dental care. MaineCare also covers children and young adults under age 21 for some specialized dental services.
● Many schools in Maine work with public health dental hygienists to offer free dental care in schools. Ask the school nurse for information.

How can I care for my dental health during pregnancy?
● During pregnancy, women should continue to brush their teeth at least twice a day with a fluoridated toothpaste, and flossing once a day to remove bacteria that can be harmful to the pregnancy.
● Some women get nauseous and vomit frequently during pregnancy. The acid in vomit can harm the protective outer covering of teeth. Rinsing with water is recommended.
● Professional dental care is safe during pregnancy.
●Pregnant women who have MaineCare may qualify for free dental care before and after pregnancy, including cleanings, cavity fillings, and extractions.

How can I find affordable dental care in Maine?
● The Oral Health Program of the Maine Center for Disease Control and Prevention (Maine CDC), an office of the Maine Department of Health and Human Services, provides a comprehensive, county-by-county list of affordable or lower-cost dental clinics and services for Maine residents. Their directory was updated in January 2021. For more information, call (207) 287-8016 or visit the online version of this article, which includes a link to the complete listing.
For dental care assistance, the Maine Oral Health Program of the Maine CDC mentions that low-income Mainers or their allies could approach municipal administrators, health officers, and public assistance directors, or local service organizations such as the Kiwanis or Lions clubs.
● Consumers for Affordable Healthcare Consumer Assistance Hotline offers a free service to help callers access affordable dental care or health insurance. Language Line interpreter services are available. (800) 965-7476
● Greater Portland Health Dental Services can help with appointments, reminders, referrals to dental specialists, and understanding dental