Submitted by achenault on Wed, 01/14/2015 – 2:10pm
More and more people are recognizing that oral health is important to overall health. Yet thousands of Ohioans can’t get affordable dental care in their communities—hurting their ability to live, learn, and work. We need new thinking about how our dental care workforce is configured. Fortunately, there is growing recognition that dental therapists are proven providers who can bring care to communities that need it most.
Dental therapists were recognized in December when The New York Times Opinion Pages series “Fixes” published its Big Ideas in Social Change, 2014. In October, Fixes featured an in-depth article on dental therapists and how they are improving access to care.
This is a significant acknowledgement. In addition to the growing number of evidence-based evaluations of the dental therapist, it should be clear that adding dental therapists to the dental team will:
We should take a cue from the medical care system, where Ohio has done a good job of modernizing our laws and removing restrictive regulations so that nurse practitioners, advance practice nurses, and physician assistants can provide needed care to more people. We need to do the same for dental care. In addition, advances in health information technology mean that dental therapists can work in remote areas and maintain contact with their supervising dentists. This is a great opportunity for us to expand and modernize dental care in Ohio. Please join us as we continue working to bring quality dental care to every community.
Submitted by achenault on Wed, 11/04/2015 – 4:13pm
What ONE profession could generate millions in economic impact in ONE Ohio county? Dental therapy!
The places dental therapists and advanced dental therapists are allowed to practice in the U.S., Alaska and Minnesota, have had success increasing access to dental care, improving oral health, and changing the lives of people who previously lived without routine access to quality dental care. While the dental therapists in Alaska were initially addressing generations of people who needed critical care – extractions and fillings – they now report that they are spending more time providing preventive services like education in Head Start programs about the importance of oral health care[1].
The improved quality of life for people without dental care is an important part of the success story of dental therapists. But the story does not end there. We are now also seeing that there are significant workforce and economic impacts being generated by the dental therapists.
In Alaska, for instance, the employment of nineteen dental therapists resulted in 76 jobs created.[2] The nineteen dental therapists had a $9.7 million economic impact on rural Alaska.
In addition to the job creation and economic impact, dental therapists, employed at half the cost of dentists, were able to increase the number of patients seen at a dental office and generate additional revenue. In a recent Marketplace story, a dentist practicing in Minnesota stated that since adding dental therapists to his practice, his revenue has doubled, he’s opened another office, he increased the number of Medicaid patients he sees by 40%, and is about to add another dentist to his practice.
If we looked at an Ohio county with Dental Health Professional Shortage Areas (DHPSA’s) – say Montgomery County which has 2 – we find that if each Health Professional Shortage Area in Montgomery County had just one Dental Therapist to serve the community, the potential total economic impact would be:
In most cases the additional jobs are both those of the dental therapist and those created in the dental field to support the work and training of the dental therapist and the dentist led team.
This is a win-win-WIN for Ohioans, dentists, dental hygienists, community health centers, and the community at large. It’s time to bring dental therapists to Ohio.
[1] Jordan, D. (2015) “Dental Therapists: An Innovative Approach to Expanding Access.” Slides presented at the National Congress of American Indians Conference
[2] Scott, MK., (2012) Strategic Assessment and 5 year Business Plan for The DHAT Educational Program: Educating Dental Therapists to Provide Care for Alaska Natives.
Submitted by achenault on Tue, 12/15/2015 – 3:46pm
Advocates and experts from across the country working to improve access to dental care for underserved populations came together recently at the Dental Access Project Convening in Portland, Oregon.
Ohio’s delegation included three distinguished dental professionals: Dr. Ed Sterling. who recently retired as the dental director of the Nisonger Center, where he spent the majority of his career treating children and adults who are developmentally challenged; Ann Naber, a dental hygienist, faculty member at Sinclair’s hygiene program, and former member of the Ohio State Dental Board; and Dr. Larry Hill, a public health dental consultant and retired dental director of the Cincinnati Health Department.
The Convening, conducted by the WK Kellogg Foundation and Community Catalyst, provides an opportunity for participants to share information on progress and strategies towards creating a more cost-effective and farther-reaching dental workforce that can improve the oral health of the nation. Topics ranged from enabling legislation efforts in various states, varied strategies being employed in the states of Washington and Oregon, financing, and communications.
Each participant returned to Ohio with renewed energy and new learnings. Ms. Naber came away with an even stronger belief that our focus should be “on providing care to the Ohio population with the highest disease rates and least access to dental care.”
She noted that “Fifty-four countries already utilize dental therapists. In Alaska, twenty-five dental therapists (DHATs) provided care to 45,000 people and created 76 full time jobs. Currently there are three funded and proposed dental therapist pilot programs in Oregon and the state of Washington. The Commission on Dental Accreditation (CODA) has adopted national standards for educating dental therapists.”
Ohio representatives learned that there are several states going through the legislative process or planning to introduce legislation to add dental therapists to the oral health team. Momentum in the lower 48 states is increasing in favor of this additional dental personnel. An important component of decreasing health disparities is empowering people to make better choices and getting communities to demand health care services.
Dr. Sterling found that the biggest change from previous convenings was the progress that is occurring in the dental therapy movement. He noted that with the recognition by CODA, there is real progress in the “lower 48.” Dr. Sterling said that while “the presentations were very positive, there are still obstacles to overcome, but they seem more manageable. The reports from the states all showed progress in the establishment and acceptance of the dental therapist as a recognized member of the oral health care team.” He concluded, “It seems that efforts to make public and oral health care providers aware of dental therapy now should be more positive. Utilizing social media to a greater extent to promote the positive side of dental therapy – e.g. what therapists are doing, their commitment to oral health, and the people they serve – should be the message, rather than what is lacking in the oral health care system. With data from Minnesota, New Mexico, and the Oregon programs, along with CODA recognition, a brighter day is dawning for oral health care.”
Dr. Hill was especially impressed with the creativity in some states to create dental therapy demonstration projects. New clinical trials are beginning in Oregon; there are 3 so far and possibly more to follow. Oregon has a statute that has been on the books for some time that allows for health care workforce demonstrations but that had not previously been applied to dentistry. That law is now the foundation for developing a dental therapy demonstration, in which, over 5 years, dental therapists will be trained and deployed to communities to expand access. Almost simultaneously, the Northwest Portland Area Indian Health Board will be gearing up pilot projects in Oregon and Washington, targeting Native Americans, under the rights of Indian sovereignty.
Also of interest was a presentation by Shelly Geshen, a policy consultant and former director of the Pew Children’s Dental campaign. Ms. Geshen spoke about the workings of state workforce boards. Every state receives federal funds to create a Workforce Board. Those funds are then distributed to local workforce agencies to help underemployed populations receive training and then assistance for employment. Populations include disconnected young folks ages 16-24, people living in low-income areas, dislocated workers, adults with low literacy, unemployed veterans, etc. It was recommended that in our efforts we become acquainted with state workforce board members and even work to get a sympathetic person on the board and then to get dental therapists into the state’s workforce plan. Currently Alaska is the only state to have done so.
Finally, Dr. Hill said that he was impressed by the suggestions of Roxanne Fulcher representing the American Association of Community Colleges. Ms. Fulcher “recommended that advocates for dental therapists work not only with dental hygiene programs within community colleges, but also with the workforce development departments. Community colleges are currently facing concerns over degree inflation which is requiring nurses to get baccalaureate degrees and therefore essentially removing those programs from community colleges. Those colleges will be looking for programs and students to replace the loss of their nursing students, which may create an opportunity for dental therapy training programs.”
Submitted by achenault on Tue, 01/12/2016 – 3:29pm
A little role reversal, please.
Imagine for a moment, in the relationship between you and your dentist, that you are the dentist. Imagine as a small business owner (your dentist), you hear this:
These findings are exactly what legislators in Minnesota heard from the Minnesota Department of Health and the state’s Dental Board after an evaluation of dental therapists operating there as members of the dentist-led team.
Now imagine that as you are considering these findings, you also hear that:
Wouldn’t you think: “It is time to give me and other Ohio dentists the choice to be able to provide more quality, affordable, accessible dental care to Ohioans that need it!” We at Dental Access Now!, including several dentists from across the state, think so. Sign up for our Day at the Statehouse on February 24th to tell your legislator why dentists should have a choice to hire a dental therapist to improve dental access in Ohio.
Submitted by achenault on Tue, 02/02/2016 – 5:31pm
As we move toward UHCAN Ohio’s Day at the Statehouse, when we will to ask our legislature to allow Dental Therapists to practice in Ohio to address the lack of access to dental care, it is important to provide answers to the most pressing questions often raised about the dental therapist.
When the issue of adding new health professionals (e.g. nurse practitioners, physician assistants) to the physician-led team surfaced, Ohio providers at first vigorously fought the new professionals, eventually acquiesced, and then over time recognized that nurse practitioners and physician assistants were essential to the provider team. During the debates, the issues of education and supervision were raised about these new providers. When it comes to dental therapists in Ohio, organized dentistry is still in the fighting stage, but we know it’s only a matter of time before dental therapists are as celebrated as nurse practitioners and physician assistants.
The adequate training and education of Ohio’s future dental therapist students was addressed recently when the Commission on Dental Accreditation (CODA) agreed to implement education standards, which were approved last February. This landmark CODA decision followed by several years the development of a curriculum for dental therapists commissioned by the American Association of Public Health Dentists and completed by a group of the country’s most esteemed dental educators.
Regarding the concern about supervision, which typically stems from our proposal to allow the dental therapist to operate under general (remote) supervision or not under direct supervision of the dentist, the following restrictions should be considered:
In all cases, the supervising dentist will choose:
We trust that Ohio’s licensed dentists have been adequately vetted, well-educated, and properly licensed and are capable of making the kinds of hiring and supervisory decisions which will best meet the needs of their patients.
While these questions require evidence-based answers, there is little question about the lack of access to routine dental care for many Ohioans. There are 84 areas all across Ohio that are already identified by the Ohio Department of Health as Dental Health Professional Shortage Areas. These HPSAs include most Appalachian counties, parts of rural northwestern Ohio, much of southwest Ohio, and parts of every major metropolitan community in the state. By definition, these are areas where there just aren’t enough dentists to meet the community’s needs. Dental therapists will make it easier for children and families in underserved communities to get high-quality, affordable dental care where they live.
Submitted by achenault on Wed, 02/17/2016 – 11:58am
UHCAN Ohio recognizes that dental hygienists are a critical part of the dental team. They provide services that keep people healthy and prevent tooth decay and other diseases. Because of the time they spend with patients, dental hygienists are leaders in providing preventive care and education that are essential to improve our dental access crisis. Because of their role in the dentist-led team, dental hygienists have a unique perspective on the value of allowing dental therapists to join the team in Ohio.
Don’t take it from us. Here’s what Barb Ranck, current President of the Ohio Dental Hygiene Association (ODHA), had to say about why ODHA supports our campaign to allow dental therapists to practice in Ohio: “If we allowed dental therapists and dental hygiene therapists to be utilized in this state, we could help so many more Ohioans and better serve those who can’t afford the necessary treatments they need! It’s really sad to look in a child’s mouth and see so many decayed teeth when I know it can be prevented.” She added that the dental therapist and dental hygienist therapist “would be able to go to the areas where people live that are unable to get to the bigger cities or even to a dentist due to transportation issues. They can provide the needed education that will help families to understand the importance of good oral care.”
Barb continued to explain, “I currently work in a pediatric office. We see many children who live in the Appalachian areas of our state. The amount of decay we see in patients under the age of three is huge. When I speak of decay, I’m referring to 3 or more affected teeth per patient. A lot of the parents are unable to afford the necessary treatment…needed to help all of our patients.” Often she says these are not patients who are enrolled in the Medicaid program, they are just poor Appalachian working people.
She talked about the impacts she sees every day, saying, “The lack of dental care creates a child [with] low self-esteem, improper development of the jaws, the inability to concentrate while in the class room, and someone that other children will make fun of (bully). I can say this because I teach once a month in a Baby Basics class sponsored by our local hospital, and one of the parents in the class shared that with the class. He is a teacher, and he commented that he had had a student in this exact situation.”
She continued, “There is a huge need that needs addressed in our state. Children would do better in school if their dental treatment needs were met, which would enhance their ability to learn, which in turn makes them better citizens.”
Barb explained that ODHA endorses the Dental Access Now! campaign “because we see the need in this state to get dental care to those who are unable to get care. Dental care contributes to our overall health. The better we take care of our mouths, the healthier we will be for a longer period in our lives.”
From our conversations with dental hygienists, we recognize that changes in law and practice are needed to allow them to work to the full extent of their training, including providing services when a dentist is not physically present. We support these changes as necessary to our goal of expanding dental care. Expanding the reach of hygienists will enable them to reach more children and adults with more preventive care and education. We’re proud to have ODHA as a partner and supporter in our mission to increase dental access in every community in Ohio.
Next week a broad coalition of advocates for improved access to dental care will be meeting with their legislators to deliver a message of hope. We will also provide details about how dental therapists and dental hygienist therapists can change the way dental care is delivered while assuring high quality services with an evidence-based provider model. For more details, contact David Maywhoor at dmaywhoor@uhcanohio.org.
