Pediatricians Step In as Maine Struggles With Oral Health Professional Shortage

Maine is grappling with a significant shortage of oral health professionals, leaving many children without timely access to routine care. Even among insured patients, only about a third of children receive both an annual dental checkup and prophylaxis. One increasingly adopted strategy involves using silver diamine fluoride (SDF), a topical solution combining silver and fluoride, to arrest early carious lesions. Traditionally used by oral health professionals SDF is now being integrated into primary care settings as training programs expand.

Pediatricians in Maine have begun offering SDF during well-child visits, identifying early decay and treating it before it progresses. The appeal of SDF lies in its ability to “freeze” decay and reduce bacterial activity, providing a practical bridge when dental access is limited. While it can cause black staining on treated areas and is unsuitable for advanced caries or children with silver allergies, it has become an essential tool for early intervention.

Beyond pediatric offices, Maine is exploring school-based and telehealth initiatives. Programs have trained school nurses and dental hygienists to identify early decay, apply SDF, and collaborate remotely with dentists for oversight. Pilot programs within Head Start and mobile dental units aim to expand preventive and minimally invasive care to underserved communities. Advocates stress that these approaches are complementary to traditional dentistry, not replacements. Expanding the use of SDF and other minimally invasive treatments can help stop caries progression, reduce oral health disparities, and allow dentists to focus on more complex procedures. Click here to read more.