By Susan Richards
As the ongoing dental hygienist shortage dominates the news, another industry profession is making an appearance on the national health scene: dental therapists.
Although dental therapy has yet to gain mainstream status in the United States, the practice has been around since 1921 where it began in New Zealand and eventually branched out to more than 50 countries. In the U.S., dental therapists have served Alaska Native communities since 2005 and they have authorization to practice in 13 states, with eight additional states currently considering laws.
A dental therapist is similar to a physician’s assistant, working under the supervision of the dentist and able to handle procedures such as fillings and extractions, thus allowing the dentist to focus on more complicated cases. One of the key purposes of the dental therapist is the capacity to treat the underserved. In fact, therapists are required in most eligible states to practice in public health, tribal lands, or in practices that serve uninsured or Medicaid patients.
New Federal Report Calls for More Support
Given the increasing need to address the inequality of oral healthcare in this country, a new federal report has been released urging support and funding for dental therapy. Supporting Dental Therapy through Title VII Training Programs: A Meaningful Strategy for Implementing Equitable Oral Health Care was recently presented by the Advisory Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD). The committee includes members from various dental and medical fields and advises the Department of Health and Human Services (HHS) on the betterment of public health.
Title VII prohibits employment discrimination based on race, color, religion, sex, and national origin, so the crux of the report calls for expanding dental teams with trained dental therapists in order to more effectively serve seniors, Natives, people of color, and rural communities. More funding is requested that will provide additional training, scholarships, and loan repayment programs, ultimately allowing more dental therapists to enter the field.
Not only are dental practices seeing a staffing shortage, but the Health Resources and Services Administration (HRSA) is predicting a deficiency of general dentists in the workforce by 2030. And unfortunately, the current number of actively practicing dentists in the U.S. – approximately 155,000 – is unevenly distributed, leaving large populations without easy access to dental care.
As reported in this year’s Surgeon General’s Oral Health in America: Advances and Challenges, the reasons and solutions for the disparity in dental care are complicated, but the expansion of dental therapy could go a long way to mitigate these issues.
Dental Therapy Receives Bipartisan Support
Although the ACTPCMD report included studies showing the benefits of dental therapists, such as increased access and preventative care, comparable dental skills, and cost-effectiveness, the opposition from dental associations has been the main roadblock to greater inclusion in more states and communities.
In recent years, however, there has been a surge of support from a variety of organizations and endorsements from both political parties for the expansion and practice of dental therapy.
The National Partnership for Dental Therapy (NPDT) noted such bipartisan support in 2020. A Democratic task force announced support that year for policies that would increase the number of healthcare practitioners, including dental therapists, particularly in rural and low-income regions. The previous Republican administration also declared support by putting dental associations and boards on notice for restricting complementary healthcare providers.
In 2008, the Pew Charitable Trusts began an initiative to improve oral health and access to expanded care, including dental therapy. In their advocacy and research, Pew cited the overuse of emergency rooms for dental pain as one indication of the need for more flexible dental care in communities.
Earlier this year, the CareQuest Institute for Oral Health joined forces with a group of 90+ nonpartisan organizations to ask Congress to lift a federal ban on accessing grants for dental therapy programs. The federal grant program was created in 2010 but has never been funded due to appropriations language prohibiting the HRSA from tapping it.
The group is requesting at least $5 million to fund the grant program and allow states to provide more resources. The NPDT added their voice to the endorsement of dental therapists along with Pew, the National Indian Health Board, MomsRising, the National Rural Health Association, and many more.
The bookend to the federal report could very well be the 2022 study by the Oral Health Workforce Research Center. The report, Provider and Patient Satisfaction with the Dental Therapy Workforce at Apple Tree Dental, found high satisfaction from dental teams, patients, and dental therapists alike.
As the dental industry continues to navigate inflation woes, staff shortages, and pandemic fallout, the groundswell of support for dental therapists seems like a movement whose time has come.
Author: Susan Richards is a staff writer at DOCS Education. With over 20 years of experience in local journalism and business marketing, Susan’s career includes award-winning feature writing, as well as creating content with context for a wide variety of industries.