About two weeks ago, James Grancio broke a tooth.
The 60-year-old retired carpenter, who lives in Linneus, was using his teeth to pry open the lid to a food container when the incisor to the immediate right of his front tooth snapped just below the gum line.
Not a big deal, he thought. He’d call Katahdin Valley Health Center in Houlton, where he already went for doctor’s appointments, to see if its dentistry practice could fit him in.
“[They said] ‘We’re not accepting new patients,’” Grancio said. “I’m like, ‘But I broke my tooth … what am I going to do?’”
So Grancio called MaineCare, his insurance provider, to make sure he was covered for emergency visits. He was, they assured him, and recommended he try the handful of other dental practices around Houlton.
He did. And then he called all the dentists in Presque Isle. No luck. So he tried those in Bangor. When that failed, he called as far south as Portland. In total, Grancio estimates he reached out to more than 30 dentists.
They either told him some combination of the same thing — they weren’t taking new patients or did not accept MaineCare — or simply didn’t return his messages.
“I called everybody under the sun. I called MaineCare and the only thing they could do was give me more names to call,” Grancio said. “The entire system is broken. It’s unbelievable.”
Grancio’s experience underscores the struggle many Mainers, especially those on MaineCare and in rural areas, have gone through to access dental care since the state expanded dental coverage to adults over 21 four years ago.
Maine is one of the few states that has seen more practicing dentists over the past decade, according to data presented to the Maine Commission to Expand Access to Oral Healthcare. But that improvement has been slow to reach MaineCare patients, who are among the state’s most vulnerable populations.
There were approximately 854 dentists practicing in Maine as of October 2025, according to insurance claim data presented to the commission. Of that, only 32% are enrolled in Medicaid — the federal framework for MaineCare, which provides health coverage to low-income individuals.
Even fewer dental specialists accept MaineCare, said Therese Cahill, CEO of the Maine Dental Association. That includes oral surgeons, who may be required to fix a broken tooth.
There is only one oral surgeon in the state north of Bangor, who is based in Presque Isle, according to licensing records. And the overall number of specialists in Maine has declined in the last four years.
“A lot of specialists, particularly in the southern Maine area, have stopped taking any kind of insurance, not just MaineCare,” Cahill said. “So that creates a huge access issue.”
Dentists have leaned away from accepting MaineCare for complex reasons, Cahill said. The most common is the reimbursement rates for care, which can be as low as 50% of what private insurance pays, retired dentist and state Rep. Lucien Daigle, R-Fort Kent, said in a November legislative meeting.
“If we try to boil it down to one thing, people always want to go to the rates, and I’m quick to go there too, but it takes a lot to work [with MaineCare],” Cahill said. “It’s always a little more difficult with the state just because it has to go through a bunch of different layers.”
The Office of MaineCare Services is opening its five-year rate redetermination for dental care this summer — a year early — in an effort to address rate issues. And the commission, which submitted its final report in January, called for legislation to reduce barriers for new dentists to enter the state’s workforce.
But now, the 30% of Mainers who are dependent on the insurance program for dental coverage are often forced to endure long wait times and long drives for care, if they find a provider that will see them at all.
After dozens of phone calls, that’s what frustrates Grancio, who still can’t find a dentist to fix the hole in his smile.
“I mean, hello, I’m missing a tooth,” he said.
