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The Case for Licensing Dental Therapists in North Dakota

January 13, 2017

A joint publication of The Heartland Institute and Texas Public Policy Foundation, this Policy Brief makes a case for the licensing of dental therapists in North Dakota to improve access to basic and preventative oral care.

African American girl in dentist's chair with dental professional

The report includes 64 footnotes citing research about the benefits of dental therapy to public health throughout the country.

An excerpt:

The question really facing North Dakota lawmakers is, “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?” 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.

The Policy Brief was written by Michael Hamilton and Bette Grande, both research fellows of The Heartland Institute, and John Davidson, a senior fellow of the Texas Public Policy Foundation. Grande served as a North Dakota state representative from 1996 to 2014, representing the 41st district.

The Policy Brief notes:

  • Approximately 66,663 North Dakotans – nearly 10 percent of the population – live in 35 areas designated as having a dental health professional shortage
  • One-third of all elderly North Dakotans (aged 65 and older) with teeth needed “early or urgent dental care” in 2016.
  • 72 percent of children on Medicaid in 2015 did not use preventive dental care for which they were eligible, the third-worst rate in the nation – despite the dentists in the state enjoying some of the highest Medicaid reimbursement rates in the country.


Dental therapists can help alleviate such problems, according to the authors, by alleviating the patient pressure on dentists for “basic preventive and restorative treatment to children and adults,” including extraction of teeth to prevent infection that will worsen one’s oral health. The dental therapists – who would be required to undergo professional training similar to medical nurses – would be supervised by professional dentists.

The authors urge North Dakota to follow the example set in Maine, Minnesota, and Vermont, which have proven that licensing dental therapists is a win-win for residents and dentistry professionals.

“Dental therapy is a 95-year-old profession with proven success at increasing oral care access for underserved patients in more than 50 countries, including the United States,” the Policy Brief states. “Permitting dental therapists to obtain licenses in North Dakota would expand access for populations rural and urban, young and old, on Medicaid and off Medicaid. Dentists, who are currently obstructed from hiring dental therapists, would gain the freedom to grow their practices by building their dental dream teams.”

Author
Michael Hamilton writes and edits for the liberty-minded clients of Good Comma Editing, LLC, a freelance writing and editing company.
media@heartland.org @MikeFreeMarket
Author
Bette Grande is a research fellow for energy and pension issues at The Heartland Institute. Prior to coming to Heartland, she served as a North Dakota state representative from 1996–2014, representing the 41st district.
governmentrelations@heartland.org @BetteGrande
Author
John Davidson is a senior fellow at the Texas Public Policy Foundation.
jdavidson@texaspolicy.com @johnddavidson