Last week we delivered a Lawmaker Letter which provided state lawmakers with details about the safety, quality care, education, and training of the dental therapist just days before the professional dental lobby group held its “day at the statehouse.” We wanted to let legislators know that they do not speak for all dentists or the many community-based and statewide organizations, including the Ohio Dental Hygienist Association, who support expanding the dental care team.
Following are excerpts from the Lawmaker Letter.
“It is no longer a question as to whether adding new providers to the dental team will expand access to quality care. Numerous evaluations prove that dental therapists will. The question that remains is when will Ohio take this critical step to improve access to care?”
We knew that lawmakers would hear concerns from organized dentistry but wanted to make sure they knew that the evidence supporting dental therapists includes the following:
Regarding SAFE, QUALITY CARE
Studies show conclusively that dental therapists deliver safe, quality care. In addition, they allow dentists to grow their practices and increase revenues while treating more patients.
The American Dental Association’s own journal acknowledged “a variety of studies indicate that appropriately trained mid-level providers are capable of providing high quality service.” There have been more than a thousand studies on the quality of care provided by dental mid-levels, and none has ever shown it to be unsafe.
A 2012 literature review of more than 1,100 studies across multiple nations demonstrates the quality of care provided by dental therapists. We have also seen it in practice here in the U.S. In Alaska, dental therapists have been able to provide quality care since 2005 to 35,000 people who previously had no opportunity for dental care. In Minnesota, one practice has been able to save $1,200 a week by adding a dental therapist to the team. That therapist cared for 1,000 people in the first year alone. A further Minnesota study shows that dental therapists are expanding access to care to low-income, uninsured, and underinsured patients. Clinics reported improved quality and high patient satisfaction in addition to reduced travel and wait times for some patients.
Regarding EDUCATION AND TRAINING
“They’ll [dental therapists] get actually more practice than a dentist does by the time they graduate. The dental therapist has a very small scope of practice. The dentist has to do multiple procedures.” –Dr. Mary Williard, the Director of the Dental Health Aide Therapist Training Program in Alaska, graduate of The Ohio State University College of Dentistry, 1994.
In February 2015, the Commission on Dental Accreditation (CODA) approved national training standards for dental therapy education programs. CODA is the same accreditation body for the education of dentists and dental hygienists. CODA adopted standards that ensure training institutions will have national and streamlined standards to shape their dental therapy programs.
The CODA approval signaled that organized dentistry’s accrediting body thought it was in the best interest of the dental profession and the public to develop national standards for the program. More importantly, the vote was recognition that dental therapy as a profession is here to stay.
Acknowledging the need for national standards and establishing them is another important step in dentistry’s path toward adopting team based providers—a step the medical community took decades ago when it expanded the medical team to include physician assistants and nurse practitioners.
Public health dentists across the country and the world promote this evidence-based approach to expanding access to dental providers. Team-based dental care that includes dental therapists can increase access to quality care in a way that is proven and cost-effective. With the number of dental health professional shortage areas in Ohio on the rise, we need to modernize our dental practice laws to expand the dental care team to include dental therapists who can treat dental disease.
