New pediatric dentist opens practice in Keene, one of few who accepts Medicaid

Aug. 31--A new pediatric dentistry practice opened its doors in Keene last week, and almost immediately, patients began flooding in. Within a few days, 40 or 50 people had called to schedule appointments for their children at Montshire Pediatric Dentistry, owner Dr. Jonathan E. Norris said.

For Norris, who moved from Windsor, Vt., to Westmoreland with his family last month and set up shop at 340 West St. in Keene, the rush of new patients has been gratifying, but also somewhat expected. Norris divides his time between the nascent practice and two other clinics -- a pediatric practice in Claremont and a family practice in Concord -- where he works as an associate. He said he's noticed some patients come for dental care from afar -- a few towns over, from a neighboring county or from Vermont.

"You always hope that you'll be well received, and you always hope that there's a need," he said of his new practice.

For now, at Montshire Pediatric Dentistry, Norris works with one receptionist and an assistant. Norris, who got his dental degree from Virginia Commonwealth University-Medical College in Richmond in 2010, cleans teeth and does procedures with help from the assistant. He completed his pediatric dental residency at Alaska Native Medical Center in Anchorage.

As the clinic ramps up, he plans on transitioning to working there full-time. Based on the need in the county and in other regions of the state, it may not take long.

Norris is one of just 55 pediatric dentists in New Hampshire, and one of a small group in the Monadnock Region.

He's also one of the select few pediatric dentists in the region who accept new Medicaid patients -- welcome news for parents who up to this point may have had to travel elsewhere for their children's care. According to Gail T. Brown, director of the Concord-based N.H. Oral Coalition, that experience is not uncommon in New Hampshire, particularly for kids who are covered by Medicaid.

"We do have a good supply of dentists in New Hampshire -- all dentists -- but they may not be where we need them to be geographically, and they may not be part of the Medicaid service network," she said.

Medicaid, a state and federal partnership that provides health and dental insurance to people of low income, reimburses providers at a lower rate than private insurance plans. For that reason, many dentists take a limited number of Medicaid patients or none at all, said Louise Danforth, program coordinator at Monadnock Healthy Teeth, a prevention and referral program of Monadnock Community Hospital in Peterborough.

Medicaid also carries a stigma, and some providers choose not to take it because they believe that Medicaid patients cancel appointments more often, Danforth said.

The southwestern part of the state, including the Monadnock Region, is one of the areas where there aren't enough pediatric dentists to serve the needs of the population, according to Brown.

A Google search indicates that Cheshire County has 13 practices that serve children, three of which serve kids exclusively.

The county has roughly 13,600 children under 18, 2017 estimates from the U.S. Census Bureau show.

According to the website InsureKidsNow.gov, which offers a directory of dentists who accept Medicaid, only one clinic in Cheshire County -- Dental Health Works of Cheshire County on Island Street in Keene -- accepts pediatric patients covered by Medicaid.

The shortage is compounded by recent shifts in dental practices in the region, Brown said. In the past two years, several pediatric dentists retired, and others stopped accepting Medicaid patients.

Up until recently, another pediatric provider, Children's Dental Care in Keene, treated Medicaid patients. But the dentist who runs the clinic, Dr. Blake C. Wullbrandt, had his license suspended in a May settlement, after the N.H. Board of Dental Examiners alleged he practiced under the influence of alcohol. In its May 8 settlement agreement, the board ruled Wullbrandt could return to his practice at the beginning of August. The agreement stipulated he be monitored by the N.H. Professional Health Program, an organization that works with health professionals with a history of substance misuse.

However, the license suspension also meant Wullbrandt lost his Medicaid provider credentials, according to Jake Leon, spokesman from the N.H. Department of Health and Human Services. Leon declined to say if Wullbrandt re-applied to restore his status with the state's Medicaid program, saying that information is confidential under state law.

Wullbrandt is still the subject of a separate criminal investigation "concerning the abuse/neglect of dental patients ..." by the N.H. Attorney General's Medicaid Fraud Control Unit, according to an October letter from the office. Sean P. Gill, director of the unit, confirmed Thursday the investigation is ongoing.

Norris, for his part, said he is still finalizing his paperwork with New Hampshire and Vermont's Medicaid programs, but in the interim, won't turn patients down. He said his practice focuses on prevention services, such as cleanings, exams and caring for baby teeth. For more complex services, such as braces and root canals for adult teeth, he said, he'd refer children to area clinics as needed.

Liora Engel-Smith can be reached at 352-1234, extension 1439, or [email protected]. Follow her on Twitter @LEngelSmithKS.

Liora Engel-Smith can be reached at 352-1234, extension 1439, or [email protected]. Follow her on Twitter at @LEngelSmithKS.

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