Some dental services may be available beginning Friday under Gov. Janet Mills’ plan for reopening the state during the coronavirus pandemic. But the scope of permitted services is unclear and Mainers may have to wait until June or later for preventive and routine care such as cleanings and filling cavities.

Heather Johnson, commissioner of the Department of Economic and Community Development, said at a daily news briefing Wednesday that dental services would be included in Stage 1 of the reopening, which starts Friday, but she didn’t go into further detail. The first stage includes health care services, hair salons, some state parks, auto dealerships and a few other businesses.

But the Maine Dental Association sent a message to dentists Thursday morning that only emergency dental work should be conducted even after May 1, based on communications with the Mills administration and guidance by the U.S. Centers for Disease Control and Prevention.

“Unfortunately, at this time we are unable to provide further clarity,” Dr. Brad Rand, president of the association, said in an email to member dentists. “The MDA continues to actively seek information and resources that will ensure the safety of our patients, our staff and the communities where we practice. We recognize that this is a confusing and extremely difficult time; we are all in uncharted territory.”

Emergency dental services were already permitted in March and April, even under the coronavirus shutdown, Rand said in a phone interview with the Press Herald. So from a practical standpoint, nothing changes on Friday.

Rand said the Mills administration referred to guidelines from the U.S. CDC, but those recommendations are broadly designed for a country that is responding to a pandemic – including hot spots like New York City and Massachusetts – and not states with lower infection rates readying for a reopening like Maine. The federal CDC guidelines say that only emergency dental care should be provided.

“Those guidelines are not meant to address the recovery phase that we as a state are starting to be in,” Rand said. “That’s the disconnect.”

Rand said the longer patients wait to have needed work, the more their oral health will decline. Simple fillings will become root canals or pulled teeth.

“You can only delay things for so long before a (oral health-related) public health crisis starts to emerge,” he said.

Rand said routine dental care may be shuttered until June unless the Mills administration changes course.

Dr. Jonathan Shenkin, an Augusta dentist who frequently lobbies the Legislature on dental legislation, said the administration’s response to dental care has been muddled, and many dentists are hurting financially.

“There has been no planning for this reopening,” Shenkin said. “Everything is reactionary by the Mills administration, and that’s not how to run an administration. The administration has had plenty of opportunities to plan for how we can get back to work.”

Jackie Farwell, Maine Department of Health and Human Services spokeswoman, said in an email response to questions that Maine is relying on federal guidance for how to open up healthcare services, and that reopening is optional as long as it can be done safely, such as securing enough protective equipment.

Asked about dentists on Thursday, Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said his primary concern is that dentists that open up do so safely with enough protective equipment.

Shenkin said he has prepared to reopen by purchasing protective gear – including N95 masks, face shields, goggles and air filtration systems – and by redesigning waiting areas to better protect patients and staff, but he still can’t reopen.

Dr. Peter Drews, a Lewiston dentist, said he has spent about $20,000 on safety improvements, completely redesigned his procedures, and secured a $160,000 Paycheck Protection Program loan from the federal government so he could reopen on May 4, and now he has to put most of his operation on hold. If he can meet the terms of the federal loan, he doesn’t have to pay it back, but he said by being mostly closed, he may not be able to meet the conditions of the PPP loan.

“I am crushed,” Drews said. “I’ve thought, ‘OK, why did I do all of this?”

He said he’s trying to follow all the rules, but feels “stuck in the middle.”

Dr. Chris Murphy, a Scarborough orthodontist, said he has been doing some telehealth for patients, but the longer he has to wait before being able to fully operate, the worse it is for patients who may need adjustments or other care.

“There’s a lot of uncertainty. Long-term, what is going to happen to us? When are we going to be given the green light?” Murphy said.

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