NCPA - National Center for Policy Analysis

Dental Therapists Could Reduce Dental Care Shortage

March 14, 2013

As the health care system becomes increasingly burdened, state lawmakers are considering new solutions to provide more care to the growing number of patients. For the dental profession, some state lawmakers have advocated the use of "dental therapists." Though there is a severe dental care access problem in America, dentists dislike the idea of dental therapists, says Politico.

  • More than 40 million Americans reside in areas with a shortage of dentists and individuals without dental access are more likely to wind up in the emergency room.
  • Dental therapists have been touted by advocacy groups and some state legislators as the solution to the problem.
  • Able to perform some of the same basic dental services, such as pulling teeth and filling cavities, without the same training, dental therapists are providing services in Minnesota and Alaska.

In both states, the dental therapists are filling gaps in coverage by traveling to rural areas and accepting all types on insurance including Medicaid and Medicare.

  • Alaska uses dental therapists as part of its Native Tribal Health Consortium and Minnesota is the only state to have passed a law licensing them.
  • Legislatures in Connecticut, Kansas, Maine, Missouri, New Hampshire, New Mexico, North Dakota, Ohio, Vermont and Washington are considering passing similar legislation to allow dental therapists to provide basic restorative care.
  • Despite bipartisan support for many of these bills, several obstacles are likely to delay their passage.

While it takes several years to build training programs to support dental therapists, the greatest resistance comes from the American Dental Association (ADA). As the professional association for dentists, the ADA is staunchly opposed to dental therapists.

  • Dentists fear that the new midlevel dental care providers could create more competition.
  • Robert Faiella, the president of the ADA, says that there is no shortage of dentists, only a distribution that centers more dentists in urban areas leaving rural areas with less coverage.

The resistance to dental therapists is similar to the opposition in the medical community 40 years ago to positions like nurse practitioners and physician assistants. With a shortage of dentists growing in some states like New Hampshire, state legislators are determined to change the law within the next few years.

Source: Kathryn Smith, "'Dental Therapists' Spark Debate," Politico, March 11, 2013.


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