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A Bangor dental clinic that serves low-income patients has seen a flood of new patients who previously only sought care for painful emergencies in the two months since the state’s Medicaid program expanded to cover routine care.

The shift in patient makeup matches what Penobscot Community Health Care anticipated late last year and completely restructured its dental center to accommodate. That extensive restructuring included laying off nearly half of its employees and ending its dental residency program.

PCHC last November laid off 31 of its 65 dental center employees, including dentists, dental assistants, hygienists and technicians. Of those, nine reapplied to the center and were rehired.

At the time, the organization released few details about the restructuring.

The agency opted to lay off employees rather than individually reassign them to new roles because reassigning people “isn’t easy and sometimes just isn’t possible,” PCHC spokesperson Kate Carlisle said.

“Making a clean break, with the option to reapply, worked best for our situation at dental,” Carlisle said. “The result was that the folks who remained are completely committed to our mission of providing care to everybody regardless of their life circumstances or ability to pay.”

The office, which serves roughly 6,700 patients, now employs 50 people, including three dentists, one orthodontist, six hygienists, 16 dental assistants and the East Coast’s only dental therapist.

PCHC hired that dental therapist, Claire Roesler, in March 2021. That addition has increased the number of patients the center can serve, PCHC President and CEO Lori Dwyer said, and the organization is working to hire a second dental therapist.

State lawmakers passed legislation allowing dental therapists in 2014, and Roesler is the state’s first.

She works under the supervision of a dentist and can do almost anything a dentist can, said Matthew Offman, a dental surgeon and executive clinical director of PCHC’s Dental Center. Her role is primarily to perform simpler procedures, such as fillings or extractions, so dentists can address patients in need of more advanced procedures like root canals and crown procedures.

In addition to laying off nearly half its dental staff last year, PCHC ended its dental residency program to focus on serving more patients looking for routine care.

Dental residents in PCHC’s 12-month postgraduate program learned to evaluate, plan and treat a patient population with a wide range of needs.

The center launched its dental residency program 12 years ago to meet a need for more dentists in Maine, Carlisle said. At the time, it was Maine’s only dental residency program and graduated four dentists each year, many of whom stayed in Maine after completing their residency.

In 2017, the University of New England opened its dental residency program in Portland, and the need for PCHC’s residency program faded.

“We thought it was time for us to sunset the dental residency program because not only would it be cost-saving, but it’s no longer needed in the way it once was,” Carlisle said. “We also knew there would be a flood of people post-COVID coming in for regular visits. That change, plus the need to sunset the dental residency, made us think it’s time to restructure our workflows.”

In addition to Maine no longer needing the dental residency, Offman said, the program didn’t advance the center’s new goal of providing regular maintenance — rather than emergency — care for the new wave of MaineCare patients.

“With a dental residency program, dentists are only there for a year, so there’s a lot of turnover, and we want to make sure we create continuity of care for our patients,” Offman said.

PCHC anticipated seeing 1,000 new patients looking for routine dental care after MaineCare began covering it on July 1, Carlisle said.

“These are people who didn’t seek care unless they had an emergency situation,” Dwyer said. “It’s going to save the health care system money because it prevents the kinds of emergent dental situations we’ve been seeing because no one in a lower socioeconomic situation had coverage.”

Offman said he’s excited to see more patients come in for regular cleanings.

“I would rather see a patient because they came in for a cleaning with their hygienist and I check on them at the end than have them be in my chair in agony,” Offman said.

The center still accepts emergency walk-in appointments, regardless of whether that person is an established patient, has insurance, or can pay for treatment.

“Dental pain is among the top two reasons why people go to the emergency room,” Dwyer said. “Our walk-in care tries to address that, but it’s not open all the time. The more prevention we provide, the less that’s going to happen over time.”

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Kathleen O'Brien is a reporter covering the Bangor area. Born and raised in Portland, she joined the Bangor Daily News in 2022 after working as a Bath-area reporter at The Times Record. She graduated from... More by Kathleen O'Brien