Dental Therapists

The gap in healthcare access between high- and low-income children exemplifies the drawbacks of the current U.S. healthcare system. That access gap is especially striking when looking at the disparities in children’s oral health and dental care.

But a new report released by Community Catalyst, a nonprofit consumer advocacy organization lobbying for improved healthcare, shows that closing that gap can be not only economically viable, but also beneficial for both healthcare providers and patients.

The report focused on mid-level dental providers in Alaska and Minnesota, and the results are promising. By providing low-cost services in these states, dental care providers are helping some of the neediest people, especially children, get the care they need. And these mid-level practitioners cost their employers in Alaska and Minnesota only 27 percent and 29 percent, respectively, of the revenue they generate.

Community Catalyst cited the American Dental Association's survey of the current state of dental care in America and stressed the need to incorporate mid-level dental providers into the bigger picture.

"Solving the country's dental health access problem will require solutions on multiple fronts, but adding mid-level dental providers and updating the current dental delivery system are critical,” the report stated. “They should not be left out of the equation."

The researchers behind the report are optimistic about their findings. "For the first time, we have a real picture of what it means to employ a mid-level dental provider," said Frances M. Kim, DDS, DrPH, who is both a general dentist and a public health researcher. "What we are seeing is that mid-level providers are providing mostly preventive care to the most economically challenged patients and are still able to generate enough revenue to ensure that dental practices that employ them can care for the poor."

What Do Mid-level Dental Providers Do?

Much of the work performed by mid-level dental providers, or dental therapists, is done to assist the larger medical team. Though laws differ by state and country, dental therapists in some places are certified to perform basic dental procedures under the supervision of a dentist. Currently, Alaska and Minnesota are the only states in the U.S. in which dental therapists can practice.

The Community Catalyst report found that the majority of the work done by dental therapists is preventive, though filling cavities is also a common procedure. According to the report, “dental therapists primarily treat children, low-income adults, Native Americans, and those who would not otherwise have access to dental care.”

Tooth decay is among the most common childhood illnesses, and attempts to bring more dental therapists to the U.S. will have the greatest impact on those children who are at a disadvantage because of socioeconomic, locational, and racial barriers to healthcare. According to Community Catalyst, it’s both a public health crisis and a matter of ethics.

What Does This Mean for Me?

Dental therapy is still a fairly new concept in the U.S., but this research could be the impetus for certifying more mid-level dental providers in order to expand dental care access across the country to those who need it the most.

"This report underscores just how critical dental therapists could be to fighting what has become the number one chronic but preventable disease affecting children," said David Jordan, director of the Dental Access Project at Community Catalyst, in a press release. "Children and families with Medicaid often struggle to find a dentist willing to treat them. In 2014, as many as 5.3 million more kids could be eligible for services, but they need providers to treat them."

Should the benefits of dental therapists gain greater attention, legislation could be the key to expanding their use to other states. The U.S. should pay close attention to dental health outcomes in countries where dental therapists have practiced for years, including the UK, Canada, and Australia.

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