Dental Therapists
In Minnesota they can fill cavities, extract primary teeth and put in crowns and spacers. Should other states do the same?
- 47 million Americans live in areas where it’s difficult to access dental care.
- 17 million low-income children go without dental care each year.
- 830,000 emergency room visits in 2009 were the result of preventable dental problems, up 16% from 2006.
See entire report by Michelle Healy in USA Today.
I think other states should do the same. A doctor is on hand in case emergncies occur or their expertise is needed. With more dental therapists, we could treat more patients and expand access to the Americans who don’t currently have access to ental care. Since the therepists are well-trained, I’m don’t see many downsides. With increased patient capacity, maybe this would lower prices.
At a conference two years ago, I met a representative from a community dental association. They had only two primary public policy issues that they lobbied for: 1) block specialty dentists from preventing community dentists from performing specialty procedures; 2) prevent dental techs from performing simple dental procedures (unless the tech worked for the dentist). In other words, their whole reason to exist was to protect the turf of primary care dentists.
Alaska also allowed dental techs to perform certain procedures. I see no reason why dental techs could not clean or whiten teeth. They could fill simple cavities and perform general checkups.
One of the dentists with the aforementioned community association told me there is no such thing as a simple filling. There are filling of unknown nature that, in retrospect, turned out to be simple. There are also other cavities that look simple that turn out to be complex. Basically, this was the argument used to prevent techs from filling cavities without working under the direction of a dentist.
Just as is common in medicine, if you gave dental techs the right to perform certain procedures, they would work with trusted dentists they know. It might be something simple as collaborating in the same office; or having a dentist review an X-ray online to confirm a diagnosis. I do not believe you would have dental techs filling or pulling teeth that didn’t need filled or pulled – at least not any worse that occurs in general denstistry.
Hmmm… Im not sure how I feel about this. If im paying for a Dentist to be doing all the work in my mouth, I think I’d be dissapointed if a dental therapist filled in. However, if the process was cheaper, I might be more apt to allowing the therapist to do the work.
And then there’s the more general question: do we need licensing? Could voluntary credentialing, perhaps combined with inspection for sanitation work just as well for most professions?
Another related question–is access to substandard work better than no access at all?
This is a tough one. It all comes down to how much training they receive. I think it’d be a good option for people with little resources, but the downside is the risk of poorly performed jobs on someone’s teeth.
If it improves access to care and perhaps makes dental costs more affordable to more people…then why not?
One thing that stood out to me though was the third bullet point on the high number of ER visits for preventable dental problems. I don’t want to be one to judge, but can there really be that extreme of a dental case that requires a visit to the ER? In my opinion that just sounds a bit too much…
I saw a documentary one time on “street dentists” in India. They cater primarily to the poor, have no licensing and use tools that look like they came out of my dad’s garage 50 years ago. Because they charge very little and just work outside on the street, the actual office dentists are complaining about them. But geez, a little competition never hurt anyone.
Pam, I read a similar article in the Wall Street Journal. It made me cringe, but it obviously serves a need. I hope we don’t import India’s street dentists. But having people who have studied dental technology, have worked in a dentist’s office and have access to the same tools would be a step above what many people have access to. I agree with Linda. Why do we need a state dental society regulating who can work as (or compete with) dentists?
@ Pam’s comments, yes I think CNN did a reporting on these dentists in India who provide these cheap and quick services out in the open. They provide a vital dental service to a population that does not have access to these services at an affordable rate.
I consider this a dental corollary to the Nurse Practitioner at the CVS Minute Clinics. The NP will not perform surgery, but he/she is more than qualified to write a prescription for an antibiotic during flu season. When I worked in the hospital, most simple nurses knew enough information to care for the majority of cases – with little to no input necessary from the attending physician.
To sum this up, if you don’t need the best dentist, don’t pay for the best dentist.
But filling the cavities is more costly!I think they can make more sophisticated ways to get the cost down!
http://www.dental.co.in/