If you’ve been following the news recently you may have seen articles about legislation trying to pass laws allowing increased use of Dental Therapists in under-served populations. There has been a lot of controversy about this subject because of exactly what a dental therapist is and their role in dental care in the United States.
Currently dental therapists are allowed to practice in Alaska and Minnesota. However, there has been discussion about other states such as Connecticut, Oregon, New Hampshire and California allowing dental therapists to practice. Dental therapists are defined by the University of Minnesota School of Dentistry as ” a licensed oral health professional who practices as part of the dental team to provide educational, clinical and therapeutic patient services. Dental therapists provide basic preventive and restorative treatment to children and adults, and extractions of primary (baby) teeth under the supervision of a dentist. Dental therapists work primarily in settings that serve low-income and under served patients, or in a dental health shortage area.”
Individuals participating in dental therapy programs have training that is significantly shorter than general dentists. A dental therapist must complete at least one year of undergraduate college course work before they can participate in a 2 1/2 year program to teach them the basic skills of local anesthesia, preventative dentistry (such as cleanings and dental sealants), uncomplicated extractions, radiology as well as diagnosis and treatment of cavities. As opposed to general dentists who, in most circumstances, must complete four years of undergraduate college, four years of dental school and in New York state a year of residency.
So what exactly is all the commotion about allowing dental therapists to practice in under served areas? There has been a question about how to address the growing need for care, especially with children, however due to therapists limited training the American Dental Association has brought up concerns that they are not equipped to provide the level of care necessary to complete many of the procedures they are being licensed to perform. And, since many are not reversible such as extractions and fillings, there should be better training of these professionals. Other organizations have made the argument that patients that have medicaid or are in areas with a poor dentist to patient ratio are unable to receive appropriate dental care due to cost of dentistry and many general dentists not accepting these patients into their practices. So the conundrum is how do we provide appropriate care for this needful population in a safe and ethical way. Are dental therapists the solution to this problem or the creation of an even bigger problem?