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Minnesota Dental Therapists Break Records, Barriers

July 11, 2017

Dentists are expanding access to health care by hiring midlevel dental providers legalized in just a few states.

The number of dental therapists licensed and practicing in Minnesota has reached an all-time high as other states consider legalizing the profession to help expand access to oral health care.

Eight years after Minnesota passed legislation allowing dental therapists to obtain licenses in 2009, Minnesota has 72 licensed dental therapists, 35 of whom are certified advanced dental therapists (ADTs), who have attained additional education and training. State law permits dental therapists to perform approximately 30 categories of services and procedures, many of which only dentists could perform before lawmakers authorized therapists to practice.

Dental therapists practice under the supervision of dentists as members of a dental team, which often includes hygienists and assistants. State law limits therapists to practicing primarily “in settings that serve low-income, uninsured, and underserved patients or in a dental health professional shortage area,” the 2016 Minnesota Statutes state.

Minnesota had 27 therapists in 2013 and 51 in 2015, according to the Minnesota Board of Dentistry. By contrast, there were 5,819 dental assistants, 4,101 dental hygienists, and 3,013 dentists working in the state in 2013.

Expanding Access

Allowing dentists to hire and supervise therapists has expanded access to oral health care for low-income Minnesotans. Approximately 84 percent of patients treated by dental therapists were enrolled in public health insurance programs in 2014, the Minnesota Department of Health and Board of Dentistry reported at the time.

One-third of all patients surveyed by the departments said their wait times for appointments in offices with dental therapists had decreased since a therapist was hired. Time spent traveling to appointments also decreased, and face time with oral health care providers increased by ten minutes per visit, the report states.  

Costs are lower as well. With dental therapists earning about half the average hourly wage of dentists, clinics estimate they’re saving $35,000 to $50,000 per dental therapist they employ. One clinic estimated saving $62,000 per therapist, according to the report.

Competitive Cure

Dr. Karl Self, director of the Division of Dental Therapy at the University of Minnesota School of Dentistry, says licensing therapists enlarges the supply of oral health care services.

“Having the marketplace incorporate over 60 new providers focused on providing care to underserved patients is a step towards improving access,” Self said.

The university’s dental therapy program is attracting more students than ever, Self says.

“Interest in our program has never been higher,” Self said. “Our pool of applicants for the class that [will start] in September was the most competitive pool that we ever had.”

Shortage Persists

Peter Nelson, vice president and senior policy fellow at the Minnesota-based Center of the American Experiment, says early signs point to dental therapy as an effective way to reach underserved patients.

“There is a shortage of dentists in greater Minnesota, and this is a key way to expand access to dental care,” Nelson said. “It’s my impression that we’re still pretty early in the rollout.”

Other states should consider authorizing dental therapists to expand access to high-quality care, Nelson says.

“I have seen no indication of a downside in terms of the quality of care patients receive,” Nelson said. “And so, to expand access, other states should seriously consider this option.”

Dental therapists have practiced in Alaska since 2003. Maine and Vermont authorized therapists to practice in 2014 and 2016, respectively. North Dakota lawmakers rejected a dental therapy bill in February 2017.

Kathy Hoekstra (kathy@kathyhoekstra.com) is a policy advisor on regulatory issues for The Heartland Institute.

Internet Info:

Matthew Glans and Michael T. Hamilton, “States Could Expand Dental Care Access with Midlevel Providers,” Research & Commentary, The Heartland Institute, May 2, 2017: https://www.heartland.org/news-opinion/news/states-could-expand-dental-care-access-with-midlevel-providers

Michael T. Hamilton, “Dentists Know Best, So Let Them Choose,” Dentistry Today, April 2017: http://www.dentistrytoday.com/news/todays-dental-news/item/1897-dentists-know-best-so-let-them-choose

Michael T. Hamilton, Bette Grande, and John Davidson, “The Case for Licensing Dental Therapists in North Dakota,” Policy Brief, The Heartland Institute, January 13, 2017: https://www.heartland.org/publications-resources/publications/the-case-for-licensing-dental-therapists-in-north-dakota

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Author
Kathy Hoekstra is the Regulatory Policy Reporter for Watchdog.org, writing about national and state regulatory issues.
khoekstra@watchdog.org