Dental Therapists Rock
AndyGoldsmith - 23/08/2017
The debate over Dental Therapists still rages on, fueled by dentists who in my opinion have a scarcity viewpoint on the profession of dentistry. I believe that there is plenty of dentistry in the United States with only half of the population visiting a dentist on a routine basis. The issue is not wether therapists will affect your practice, it is wether the patients they serve are receiving adequate access to care and a majority of dentists live and practice in settings where there is not an issue with access to care. If we want to truly battle this issue, then we need to discuss how to increase access to care and how to get dentists to serve underserved populations. Otherwise, the debate will be one of, “since the dentists do not seem to want to serve these populations, how can we make this happen?”
In 2009 the State of Minnesota became the first state to fully recognize the position of Dental Therapist, Alaska notwithstanding.
Minnesota law defines specific educational, examination and practice requirements for licensed dental therapists and advanced dental therapists. One of the most distinctive is the provision that dental therapists practice in settings serving primarily low-income, uninsured and underserved 10 patients, or in areas designated as Health Professional Shortage Areas (HPSAs) for dental care.
In 2014 the State of Minnesota released a study on the workforce with an emphasis on the 5 year impact of the Dental Therapists as well as outcomes and recommendations here are some of the findings:
No disciplinary actions have been taken by the Board against dental therapists.
study sites also reported an increase in access to oral health services for those traditionally underserved.
A hospital site is using a dental therapist to provide oral health services to low-income pregnant women directly in its OB department. In the past, these patients were referred to the hospital’s emergency room. The dental staff explained these services are only possible because of the dental therapist; the grant-funded program could not afford to employ a dentist.
Several clinics noted that most of the new patients being seen since the dental therapist started are public program enrollees or are uninsured.
Combined with the overall reduction in wait times, the findings are an early indicator of the potential for dental therapists to reduce hospital emergency department use for dental pain.
Of those patients who had not visited the current dental clinic before, 24 percent experienced a reduction in the time it took to travel to the current dental appointment with the dental therapist.
estimated savings per dental therapist is estimated to be $35,000-$50,000 over the cost of a dentist.
While the reimbursement rates are the same regardless of services being provided by dentists or Dental Therapists, There are increased numbers of patients being seen because clinics can afford more dental therapists to provide greater amounts of care to more patients.
In general, it can be concluded that the dental therapy workforce is growing and appears to be fulfilling statutory intent by serving predominantly low-income, uninsured and underserved patients. Dental therapists appear to be practicing safely, and clinics report improved quality and high patient satisfaction with dental therapist services. Clinics employing dental therapists are seeing more new patients than before the arrival of the dental therapists, and most of the patients are enrolled in public programs or otherwise underserved. Dental therapists have made it possible for clinics to decrease travel time and wait times for some patients, increasing access Benefits attributable to dental therapists include direct costs savings, increased dental team productivity, improved patient satisfaction and lower appointment fail rates. Savings from the lower costs of employing dental therapists are making it possible for clinics to expand capacity to see public programs and underserved patients. Dental therapists offer potential for reducing unnecessary ER visits for non-injury dental conditions. The debate will continue to rage on but from the perspective of increasing access to care, dental therapists rock and since access to care is such a significant social responsibility, dental therapists are not going away.
The next iteration of the debate will be in limiting scope of practice and that will be where organized dentistry needs to bet the farm. As a profession we will need to stand-up for clear definitions of scope of practice as well as how our profession can approach this subject head-on.
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