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V O L . X X V N O. X X S E P T E M B E R 1 6 , 2 0 1 9 22 H E A LT H C A R E B efore some of the biggest issues affecting health in Maine can be attacked, providers have to figure out how residents in rural underserved areas, or even those in urban areas but lacking insurance and money, can be connected with services. Some providers are finding innovative ways to do just that. Here are two of their stories. Technology, collaboration bring dental care to Monson Construction is underway in Monson, in central Piscataquis County, for a dental clinic that will address a vital health care gap in the state's least-populous county. Falmouth-based Community Dental will run the clinic as part of a health care collaboration with Northern Light Health and the Libra Foundation. e clinic, being built in the former elementary school on Greenville Road, which has housed the arts center for the past few years, will also include optometry and primary health care. e arts center is moving to 8 Greenville Road, in the heart of downtown Monson. e clinic is expected to open in November. As revitalization takes hold in Monson, spurred by $10 million in investment by the Libra Foundation, "A key factor [that's an obstacle to a sustainable economy] is how difficult it is to access dental care," says Peter Bates, former chief medical officer at MaineHealth, who consulted on the project. Two other issues addressed by the health center will be optometry, which will be provided at the health center by Waterville-based Eye Care of Maine, and a primary care clinic by Northern Light C.A. Deane Hospital of Greenville. All three will operate out of the clinic a couple days a week and share some administrative staff. Profound effects e lack of access to health care, and specifically den- tal care, has a profound impact on a person's physical and mental health, those behind the clinic say. When someone has dental issues that aren't treated, "Life has changed, and not for the better," Bates says. Jeff Walawender, Community Dental executive director and chief dental officer, agrees. "I see it every day," he says. "For people living below the poverty level, oral health disease is not only devas- tating but tremendously expensive, and not just for the patient, but for the system, too." Poor dental care has been associated with cardiovas- cular disease. But he adds that issues like replacement of missing teeth can not only affect a person's physical health, but their mental health. "It's devastating to self-worth," he says. "I see people hanging onto teeth that are infected in order to maintain their physical appearance not only for their self-esteem but also to aid in employment opportunities. It's heartbreaking and not a position anyone should be placed in." e dental model at the Monson clinic will keep costs down while providing needed services, he says. Community Dental also has clinics in Portland, Biddeford, Lewiston, Rumford and Farmington. "Monson's not a large town, and it's not in a popu- lated area," Walawender says. Traditionally, dental practices need 1,500 to 2,500 active patients per full- time dentist. Because Community Dental treats many patients who are on Medicaid, which only covers urgent dental care for adults, those numbers need to be even higher because patients visit less consistently. e biggest challenges to dental care access in Maine are cost and geography, Walawender says. PRESCRIPTION FOR MAINE'S HEALTH: It's all about access Geography, money are barriers to solving some of the state's biggest health care challenges B y M a u r e e n M i l l i k e n F O C U S C O N T I N U E D O N PA G E 2 4 » Jeff Walawender, executive director and chief dental officer at Community Dental, cites oral health issues among Maine's biggest health care challenges. P H O T O / J I M N E U G E R

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