The dental landscape in Maine is deeply flawed and demands attention.

Across the state, there is one dentist for every 2,100 people. (Or, in terms of teeth, one for every 67,200.) In northern Maine, there is one dentist for every 4,000 people. Lack of access to care affects all dental patients universally; it is not a problem that money alone can fix.

Full-fledged reform, however, could.

Last year, the governor’s task force on oral health sparked discussion by delivering 14 policy recommendations. Predictably, greater MaineCare reimbursements (Maine’s rates are among the lowest in New England) and stronger incentives to attract dentists were atop the list.

These should be done. Although MaineCare consistently runs a deficit – which has the GOP gnashing its teeth at the moment – the dollars it does spend should be geared, as much as possible, toward preventive care, rather than major (read: expensive) treatments.

Dentists are refusing to see MaineCare patients because the reimbursements are so poor. This almost guarantees that, like an emergency room visit for medical care, dental care is being sought and provided when it has become dire, which is also when it is most expensive.

So not only is Maine not paying enough for services under MaineCare, it is also failing to get its money’s worth. Higher reimbursements are a long-term investment into better, accessible care for patients. Right now, the public’s money is being spent unwisely.

(And it is a national problem. Dental care, according to the National Conference of State Legislatures, is less than 1 percent of the entire budget of Medicaid.)

More important, however, is giving oral health the same attention, scrutiny, legislative effort and administrative expertise as medical health. So far, Maine’s laudable efforts to expand health insurance and access to care has targeted physicians and hospitals, with good results.

Dental care, given its desperate state in Maine, merits the same focus. Too many correlations between dental health and physical health exist, and too many patients with dental pain walk into hospital emergency rooms, to treat oral health anything less than equally.

(Unsurprisingly, the paucity of dentists in Maine has allowed doctors to start offering basic dental treatments, such as extractions, in their practices, under a four-year-old state program.)

The state of dental care in Maine is a parable for dentistry – a problem that needed attention, but for reasons of finances and poor priorities, has turned into a major malady. For the recalcitrant patient, then, the only solution is to get the overdue treatment, however painful.

Dealing with oral health in Maine now requires the same resolve, and a willingness to accept a little pain in the short term in return for better, healthier days ahead.