Amalgam vs. Composite: Filling in the Blanks

By Cedric Jackson

Understand what a dental therapist can do, the states expanding their licensing and the potential impact they could have on your practice and community.

Numerous barriers to dental care prevent millions of Americans from visiting the dentist each year. The American Dental Association created Action for Dental Health to address various problems that people face. However, some practices have decided to take a more proactive approach by hiring dental therapists.

What Does a Dental Therapist Do?

Dental therapists are similar to physician assistants. They are trained to handle various routine, preventive, and restorative dental needs. These include taking X-rays, polishing teeth, filling cavities, and replacing crowns.

Interested parties can become dental therapists after earning a bachelor’s degree. They have the option of continuing their education by completing a master’s degree program to become an advanced dental therapist. Both operate under the direction of a licensed dentist. However, dental therapists can only see patients that have already been evaluated by the dentist, while advanced dental therapists do not work under that restriction.

Laws Regulating Dental Therapists

Dental therapists are regulated on a state-by-state basis. Currently, practices can hire dental therapists in:

  • Minnesota

  • Maine

  • Vermont

  • Arizona

  • Michigan

  • New Mexico

  • Nevada

  • Connecticut

Other states allow dental therapists to operate on tribal lands. You can hire a dental therapist if your practice is located on tribal lands in:

  • Alaska

  • Washington

  • Idaho

  • Montana

The state of Oregon has also held a pilot program for dental therapists in offices. Dental therapists permanent authorization in Oregon is currently under consideration.

Views on Dental Therapists

The American Dental Association agrees that removing barriers to receiving dental care should be a priority. However, the organization states that increasing Medicaid funding and improving health worker outreach is the solution. These strategies will allow dentists to treat people in underserved communities instead of adding a new provider category.

Despite the ADA position, bipartisan political support has grown for dental therapists. Both Democrats and Republicans have called for states to allow dental therapists to practice, so underserved communities can receive the same care as others.

This creates an interesting problem. On the one hand, providing patients with access to licensed dentists is clearly the best path forward. However, the ADA’s call to action requires political support. Unless more funds are allocated to Medicaid for dental expenses, the ADA’s proposal will not work.

In the meantime, practices can benefit from providing patients with access to dental therapists. Over time, if Medicaid offers more money for dental care, the need for dental therapists might wane. However, that is not the political reality at this point.

Benefits of Hiring Dental Therapists

With the ADA on one side and public policy on the other, deciding if you should or shouldn’t hire a dental therapist can be overwhelming. Go over some of the benefits to get a better idea of what to do moving forward.

Pew Charitable Trusts analyzed a quantitative study conducted by the Center for Health Workforce Studies at the University of Albany School of Public Health in New York. The study analyzed data from more than 76,000 patients who went to two Apple Tree Dental clinics in Minnesota from 2009-2019. By comparing data before and after the clinics began using dental therapists, the researchers determined the impact.

The study shows that practices enjoy a boost in productivity after adding dental therapists. Dentists went from seeing 11 patients each day to 14 during the eight years after hiring dental therapists. The procedures increased from 22 to 26, and daily gross revenues went from $3,605 to $4,194.

Dental therapists also enjoyed increased revenue and productivity over the eight-year period. They went from seeing 14 to 19 patients a day and increased daily procedures from 20 to 28. They also increased the daily gross revenue from $2,341 to $3,065.

What to Consider Before Hiring a Dental Therapist

The economic impact and the ability to serve more patients make dental therapists an attractive option for practices. However, before you move forward with a dental therapist for your practice there are some things to consider.

First and foremost, make sure that your practice is eligible. If your state does not allow dental therapists yet, monitor the legislative activity.

You also need to determine the scope of practice for the dental therapist. This will also determine how involved you will be. If you want to be less involved choose an advanced dental therapist so you will not have to see the patients first.

Make sure that you have an appropriate patient load to support a dental therapist. If you do not currently have enough patients, see if you can identify an area in the market you can serve once you have a dental therapist.

You should also consider outreach before hiring a dental therapist. How will people know about your new provider? What can you do to educate the community?

Help Your Practice and the Community with a Dental Therapist

Dental therapists can help you increase productivity and revenue while helping more patients receive care. Medicaid might help pay for more dental services in the coming years, but dental therapists can address this problem until then. Research the laws governing dental therapists in your state (DOCS members can ask DOCS Regulatory Counsel). If dental therapists aren’t currently allowed, you can lobby the legislature to take action to help you grow your practice and serve the public.


Author: Cedric Jackson specializes in finding proactive ways for dental practices to serve the community and increase revenue. This includes researching current legislation related to dental therapists.

The information contained in this, or any case study post in Incisor, should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 3250 Airport Way S, Suite 701 | Seattle, WA 98134. Please print a copy of this posting and include it with your question or request.
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