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Arizona Enacts Dental Therapy Licensing Law

June 19, 2018

Arizona Gov. Doug Ducey signed a new dental therapy law that allows midlevel dental practitioners to provide preventative and restorative dental care to patients in the state.

The Arizona government now allows dental therapists to practice in the state.

Gov. Doug Ducey signed HB2235 into law on May 16. The new law allows midlevel dental practitioners to provide preventative and restorative dental care to patients in the state. Rural areas, particularly Native American communities, will be particularly affected because they have scare resources for dental care.

‘An Extremely Positive Phenomenon’

Charlie Katebi, a state government relations manager with The Heartland Institute, which publishes Health Care News, says legalization of dental therapists is part of a growing trend improving access to health care.

“Midlevel providers such as dental therapists and advanced practice registered nurses will play a growing role in America's health care system,” Katebi said. “This is an extremely positive phenomenon. The nation’s patient population is aging rapidly and is demanding greater quantities of health care services, and there simply aren’t enough physicians and dentists available to deliver health care to all these patients. Midlevel providers, on the other hand, cost far less to educate and have proven they can deliver a variety of preventive and primary care services just as effectively as doctors and dentists.”

Katebi says dental associations, which are made up of traditional dentists, are under the misapprehension dental therapists will reduce the number of patients traditional dentists treat.

“Dental associations typically oppose proposals to license dental therapists, because they fear these midlevel providers will take their patients and market share,” Katebi said. “But the reality is dental therapists actually allow dental offices to treat more patients. After Minnesota started licensing dental therapists, these midlevel providers partnered with dentists to deliver routine and preventive procedures, which freed up dentists to deliver more complex procedures that generate higher revenue.”

Reaching Rural Communities

Kim Russell, executive director of the Arizona Advisory Council on Indian Health Care, says the dental therapy law was designed to reach rural communities and provide jobs as well as dental care.

“A main reason for the dental therapy bill’s passage was to extend the reach of the dentist into hard-to-reach parts of tribal communities,” Russell said. “Expanding the dental team to include a midlevel provider that can conduct extractions and fillings does just that. In addition, the creation of this new dental workforce would open up more job opportunities for tribal communities. These communities that may never have expected to get dental care could make the new law very successful.”

‘A Low-Cost Option’

Russell says the cost savings of deploying dental therapists to Native American communities will extend to the clinics as well as the public.

“Dental therapists would create a low-cost option for everyone,” Russell said. “Although there are some community members that have their own dental insurance through their employer, most tribal members do not, due to the lack of employment opportunities on tribal reservations. Some reservations in Arizona have unemployment rates as high as 50 percent. Dental therapy opens up job opportunities to the unemployed, and because a dental therapist's salary is less than that of a dentist, it is economical for the dental clinic.”

Medicaid Accepted

Katebi says Native Americans in rural communities will benefit from the new law, in part because dental therapy allows patients who use Medicaid to be treated when traditional dentists might turn them away.

“Licensing dental therapists would enormously benefit Native Americans, who typically live in rural areas that have scarce supplies of dentists,” Katebi said. “And even when dentists are available, many refuse to accept Medicaid, which many low-income native communities rely on to pay for their health care.

“Dental therapists have demonstrated they can improve the oral health in these rural communities,” Katebi said. “Ever since native Alaskan tribes partnered with dental therapists in 2005, these midlevel providers have expanded access to routine dental care and helped reduce preventable dental health conditions such as tooth decay.”

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Health Care
Author
Sarah Lee is a policy advisor for health care and a host of Heartland's Health Care News podcast.
slee@heartland.org