by Jordan Roberts
Former Director of Government Affairs, John Locke Foundation
A recently published article in Inside Dentistry by Frank Catalanotto describes the benefits of dental therapy:
Dental therapists help dentists provide quality oral healthcare to more patients. A literature review of 1,100 studies and evaluations assessed dental therapists’ performance in 26 countries and concluded that dental therapists provided various services with a level of safety and quality that was on par with that of dentists. In addition, the senior author of a systematic review of the dental therapy literature conducted by the American Dental Association’s Council on Scientific Affairs in 2013 commented that “the results of a variety of studies indicate that appropriately trained midlevel providers are capable of providing high-quality services, including irreversible procedures such as restorative care and dental extractions.”
The Yukon-Kuskokwim Health Corporation, a part of the Alaska Tribal Health System, serves 25,000 native Alaskans. An analysis from 2006 to 2015 showed that high exposure to dental therapists was associated with a reduction in the number of extractions involving the front four teeth in children under the age of 3, an increase in preventive care for children under the age of 18, and fewer extractions and more preventive care among adults.
Dental therapists work under general supervision; therefore, they can be used by private and public practices to extend office hours into evenings and weekends without a dentist required to be on-site. They also work remotely in underserved areas or at off-site locations, such as schools, day care centers, and nursing homes, to bring care to those who face challenges traveling to a dental office.
Private, for-profit dental clinics located in designated dental health professional shortage areas in Minnesota increased revenue and the number of patients served with the addition of dental therapists. Main Street Dental Care, a private practice in Minnesota, made an additional $24,000 in profit and served 200 more Medicaid patients in its first year with a therapist. Overall, the practice increased patient visits by 27%. The net benefit for Grand Marais Family Dentistry was 13% of its average monthly revenue, and the clinic increased the number of patient visits by 17%.
Apple Tree Dental Clinic, a nonprofit organization in Minnesota, sends a dental team, including a dental therapist, to provide on-site care at a nursing home for veterans. The dental therapist provided 8-to-10 dental visits each day for an average daily production of up to $3,122. The average employment costs per day for the dental therapist were $222 less than what they would be for a dentist, which resulted in a total savings of $52,000 per year for the practice.
Dental therapists aren’t a highly utilized profession in the United States, except for a handful of states. However, given the shortages of dental professionals, especially in states that have large rural populations, dental therapists could be one solution to increasing access and affordability in dental care. Dental therapists, if given the proper regulatory framework, can travel and treat patients under the “supervision” of a dentist. This allows populations who traditionally have barriers to care to have increased access. The North Carolina General Assembly could consider this as a possible healthcare reform to increase the amount of highly-trained dental practitioners in NC.
For more information about dental therapy, check out this report I co-wrote with Jennifer Minjarez of the Texas Public Policy Foundation or watch the panel discussion on dental therapy that was hosted by the John Locke Foundation.