A bill increasing the number of dental care providers will help address a severe dental care problem in the Berkshires and state. Increasing MassHealth reimbursements, however, is crucial to a long-term solution.

State Representative "Smitty" Pignatelli, a Lenox Democrat, has introduced legislation creating a new level of dental practitioner between a dental hygienist and a dentist (Eagle, April 20). Modeled after a Minnesota program, the dental hygiene practitioner would perform routine dental procedures and ideally free dentists for more severe problems and to nip potential problems in the bud.

A recent Health Policy Commission report found that Berkshire County residents seek emergency room treatment for dental problems at the second highest rate of any geographic group in the state. This is four to seven times more costly than treatment in a dentist's office, and as many of those treated are low-income residents or children, these high costs often get passed on to the state, and its taxpayers.

The mid-level dental practitioner should lessen this reliance on emergency room treatment. But as Representative Pignatelli acknowledges, a state health care plan that reimburses dentists for only 40 to 50 cents on the dollar makes it difficult for dentists to treat those patients while remaining economically solvent. Again, residents on MassHealth are in large part low-income, and if they do not get regular dental care they end up being treated in costly emergency rooms.


The combination of a new mid-level dental practitioner and better MassHealth reimbursement could go a long way toward addressing a painful and expensive problem in the Berkshires. Residents can help by establishing a dental home for their children at the age of one and by insisting that their children regularly brush and floss and avoid sweets. Preventing problems is preferable to finding ways for government to address them after they have arisen.