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Dental Therapists Can Fill Kansas’ Dental Gaps

February 20, 2018

In this Research & Commentary, Charles Katebi examines Dental Therapy and a proposal in Kansas that would expand access to dental care for rural patients.

Kansas faces an oral care crisis. According to the U.S. Department of Health and Human Services, an estimated 1.4 million Kansans, including 342,000 children, reside in 87 counties designated as “Dental Care Health Professional Shortage Areas” (HPSAs). Fortunately, a group of Kansas lawmakers want to expand access to dental care by allowing mid-level dental providers to offer oral care treatments.

The Kansas Committee on Public Health and Welfare recently endorsed legislation to permit dental therapists to perform a variety of dental services, including tooth restorations, tissue conditioning, brush biopsies, and many other services.

The case for expanding the scope of practice for these mid-level providers is stronger now than it has ever been. In the coming years, a growing number of Kansans will be reaching retirement age and demanding an increasing amount of dental treatments. At the same time, a growing number of dentists will also be reaching retirement age and hanging up their lab coats.

Dental therapists can help satisfy Kansas’ oral health care needs. These trained professionals already provide a variety of routine treatments under the supervision of dentists in private practices, as well as community settings such as schools and nursing homes. And unlike dentists, who must train for four years and pay more than $270,000 for schooling, therapists and hygienists can get certified within two years and pay as little as $36,000 for their education. This allows mid-level providers to more easily enter the marketplace and provide less expensive treatments to patients.

Rural communities are especially likely to benefit from improved access to basic dental services. After Minnesota became the first state to license mid-level professionals in 2009, the state’s Office of Rural and Primary Care found one-third of all Minnesotans experienced a reduction in wait times to receive dental care. The Office of Rural and Primary Care concluded , “Patients visiting rural clinics were nearly two times more likely to experience a reduction in wait time compared to their urban counterparts” after they introduced dental therapists.

Despite this success, dental associations continue to vehemently oppose allowing mid-level professionals to assist dentists in their work. In 2017, the Kansas Dental Association warned elected officials about the “damage that can be done on so many levels to the children of Kansas” if dental therapists treat them.

Nothing could be further from the truth. More than 1,100 studies across 26 countries have found dental hygienists and therapists provide patients safe and effective care. Even the American Dental Association’s Council on Scientific Affairs concluded that “the results of a variety of studies indicate that appropriately trained midlevel providers are capable of providing high-quality services, including irreversible procedures such as restorative care and dental extractions.”

Dental therapists have proven to be safe and affordable providers of oral health care treatments in America and abroad. Lawmakers in the Sunflower State should free these qualified professionals to treat all Kansans, especially those who are most vulnerable.

The following documents provide additional information about dental therapy.

 

The Case for Licensing Dental Therapists in North Dakota
https://www.heartland.org/_template-assets/documents/publications/Policy%20Brief%20Dental%20Therapy%20North%20Dakota.pdf
In this Policy Brief, Michael Hamilton, Bette Grande, and John Davidson ask North Dakota lawmakers: “Does licensing dental therapists in North Dakota pose a risk to public health great enough to justify depriving (1) dentists of their right to employ and supervise dental therapists and (2) patients of their right to access providers of their choice?” They argue the answer is clearly “no.” Far from jeopardizing the public health, licensing dental therapists would likely expand patient access to high-quality oral care services and reduce oral care costs in North Dakota.

Dental Utilization for Communities Served by Dental Therapists in Alaska’s Yukon Kuskokwim Delta: Findings from an Observational Quantitative Study
https://www.heartland.org/publications-resources/publications/dental-utilization-for-communities-served-by-dental-therapists-in-alaskas-yukon-kuskokwim-delta-findings-from-an-observational-quantitative-study
This study from the University of Washington examines whether dental utilization rates in Alaska Native communities were associated with the number of dental therapist treatment days and quantifies differences in dental utilization rates between communities without dental therapist treatment days and those communities with the highest number of dental therapist treatment days.

Early Impacts of Dental Therapists in Minnesota
https://www.heartland.org/publications-resources/publications/a-review-of-the-global-literature-on-dental-therapists
The Minnesota Department of Health and Minnesota Board of Dentistry examine in this report how authorizing dental therapy in Minnesota resulted in increased access for previously uncared-for patients.

A Review of the Global Literature on Dental Therapists
https://www.heartland.org/publications-resources/publications/a-review-of-the-global-literature-on-dental-therapists
This report from the W.K. Kellogg Foundation provides a 460-page review of the benefits of dental therapy as demonstrated in more than 50 countries.

Dental Care Health Professional Shortage Areas (HPSAs)
http://kff.org/other/state-indicator/dental-care-health-professional-shortage-areas-hpsas/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D  
The Kaiser Family Foundation analyzes the dental-health professional shortage areas in each state in order to show which states have the largest discrepancies in dental-care access.

Pew Charitable Trust: Dental Campaign
http://www.pewtrusts.org/en/projects/dental-campaign
Pew Charitable Trust has been providing research and analysis to encourage state lawmakers to allow dental therapists in their states to ensure patients have greater access to preventive and restorative treatment services. “Pew’s dental campaign works to close gaps in dental-care access by increasing the number of available providers and expanding the reach of preventive services through the use of dental sealant programs in high-need schools. Research shows that such programs are a valuable, cost-effective way to treat the children most at risk of tooth decay.”

5 Dental Therapy FAQs
http://www.pewtrusts.org/en/research-and-analysis/q-and-a/2016/04/5-dental-therapy-faqs  
While states continue to grapple with what dental therapists are, how much education dental therapists receive, and where therapy is practiced, Pew Charitable Trusts has put together a helpful FAQ page to answer the most important and difficult questions related to dental therapy.

Older Americans Need Better Access to Dental Care
http://www.pewtrusts.org/en/research-and-analysis/fa
ct-sheets/2016/07/older-americans-need-better-access-to-dental-care
   
Almost 40 percent of seniors did not visit a dentist in 2014. As the number of older Americans increases in the coming decades, the demand for care for this age group will intensify. In this fact sheet, Pew Charitable Trusts examines the health risks seniors currently face, from poor access to mental health services to dental-care barriers. “The use of dental services declines as people age due to a variety of factors. Perhaps the single greatest barrier is the inability to afford care. Seniors with dental insurance are 2.5 times more likely than those without coverage to visit a dentist, and about half of seniors lacked insurance in 2015.”

 

Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute. For further information on this subject, visit The Heartland Institute’s website, and PolicyBot, Heartland’s free online research database. 

If you have any questions about this issue or The Heartland Institute’s website, contact Charlie Katebi, The Heartland Institute’s state government relations manager, at ckatebi@heartland.org or 978-855-2992.

Author
Charlie Katebi was a state government relations manager at the Heartland Institute.