Policy Tip Sheet: Dental Therapy is an Answer to Florida’s Dental Health Shortage
In this Policy Tip Sheet, Matthew Glans examines Florida's dentist shortage and how creating a new license for mid-level dental therapists could be one solution to expand the availability of dental care.
Like many states, Florida is suffering from a dentist shortage. Currently, there are 52.3 dentists per 100,000 Florida residents, compared to a national average of 60.8 according to the James Madison Institute. In fact, the U.S. Department of Health and Human Services (HHS) designated 240 Florida regions as Health Professional Shortage Areas (HPSA) and more than 5.5 million Floridians live in these areas, according to the Kaiser Family Foundation.
At the state level, strict licensing requirements reduce dental access and increase costs. Supporters of strict licensing standards argue they assure quality care. However, critics claim the arduous and expensive licensing process is a barrier to entry that hinders new providers from entering the market, thereby impeding market competition that would inevitably reduce costs and increase patient access.
Dental health is important and overlooked: 101 Americans died in hospital emergency departments from 2008 to 2011 due to preventable dental disease. Dental discomfort and pain place a burden on emergency rooms.
Fortunately, for states with a lack of dental services, there is a simple solution that would expand dental care access and lower costs: dental therapists (DT). Indeed, states across the country are increasing the number of licensed DTs to help relieve dental shortages.
The path to becoming a DT requires significant training. However, it is far less costly and time consuming than what is necessary to become a dentist. DTs are allowed to provide a limited range of services. Therefore, they can typically complete their education requirements for about $36,000.
Typically, DTs can perform up to 95 services and procedures, compared to about 40 performed by dental hygienists and 30 performed by dental assistants. Allowing DTs more freedom to perform basic services would free up time for dentists to focus on complicated cases.
Moreover, children and adults served by DTs receive more frequent preventive care, which leads to a reduced need for invasive procedures over the long term, according to a report in the Journal of Public Health Dentistry. As the Pew Charitable Trusts notes, mid-level providers like dental therapists are already authorized to provide routine preventive and restorative care in more than 50 nations.
As is the case with all reform efforts, scope and details matter. In general, DT laws should require general supervision only, which means DTs would not need direct supervision from a dentist when providing certain dental services. This is important because limiting DTs to direct supervision would not substantially increase dental access.
Point 1: Dental therapy is a century-old profession with proven success at increasing oral care access for underserved patients in more than 50 countries, including the United States.
Point 2: Permitting dental therapists to obtain licenses in Florida would expand access for rural and urban populations, young and old patients alike, and especially those on Medicaid.
Point 3: Allowing dentists to expand their practices through the hiring of dental therapists will help patients receive preventive and restorative treatment in a timely and affordable manner.
Point 4: Florida lawmakers have excellent examples from which to draw in crafting dental therapy legislation including recent successful efforts in Arizona, Minnesota, and Vermont.
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