Three states are empowering dental therapists to perform some tasks that previously were done by dentists. Dentists say the shift could weaken the quality of patient care because therapists are not sufficiently trained, an assertion therapists dispute.
Vermont became the latest state earlier this summer to recognize dental therapists, which are licensed dental hygienists who have gone on to complete a dental therapy graduate program. The Green Mountain State joins Maine and Minnesota in allowing dental therapists to practice under the supervision of a dentist. The Alaska Native Tribal Health Consortium also recognizes dental therapists to help on tribal land but state lawmakers have not formally passed legislation that would allow them to practice statewide. A therapist can provide oral health care services including filling cavities, placing temporary crowns, drilling and restoring teeth and extracting teeth while a hygienist is more focused on routine care like cleanings.
Democratic Gov. Peter Shumlin said in a June 20 news release that the new state law “will improve access to high-quality, cost-effective dental care for Vermonters in all parts of the state."
"This is important because there's a direct connection between oral health and overall health,” Shumlin said. “Having dental therapists available to work with dentists and hygienists will make it easier for Vermonters to get the care they need, closer to home and no matter what type of insurance they have.”
More states are considering recognizing dental therapists as they look for ways to help more residents access dental care. A report released February 2015 from the Department of Health and Human Services’ Health Resources and Services’ Bureau of Health Workforce projected a shortage of 15,600 dentists nationwide by 2025.
"This new member of the oral health team would increase access for Vermonters and provide additional career opportunities for dental hygienists," according to a news release from the American Dental Hygienists' Association.
The Commission on Dental Accreditation, the national accrediting agency for dental, allied dental and advanced dental education programs, last year started allowing dental therapists accreditation on Aug. 7.
Members of the American Dental Association, or ADA, are raising concerns about the duties of dental therapists.
“It is in the best interests of the public that only dentists diagnose dental disease and perform surgical and irreversible procedures,” stated an ADA news release from August. “When it comes to affordability and access to health care, there is no one-size-fits-all solution.”
Jane S. Grover, director for the ADA’s Council on Access, Prevention and Interprofessional Relations, said in an interview that plenty of dentists are graduating but there needs to be a greater focus on connecting patients with dental care. She said since many patients are unaware that they have access to dental care, many are not utilizing the services. She points to the ADA’s Community Dental Health Coordinator program, which puts dentists in underrepresented areas, as a way of helping with this problem.
“The dentist-producing machine is running full throttle," Grover said.