Florida has become a targeted state for dental therapy legislation. Apparently, Pew Charitable Trusts, Kellogg Foundation, some dentists in academia and several other groups believe that the current dental team is insufficient to treat Floridians. Not only are they pushing dental therapy legislation as the solution to access to dental care, they have taken negative tactics to disparage organized dentistry for pursuing initiatives to help increase dentists working in underserved areas. Why are these groups and organizations investing millions of dollars in pushing dental therapy legislation, instead of investing these funds in programs that could help provide direct and immediate dental care?

The Florida Dental Association (FDA) does not support adding a new licensed dental provider to the dental workforce. Florida currently has approximately 14,000 licensed dentists and 14,000 licensed dental hygienists practicing in the state, based on information provided through the Department of Health’s website. Florida has the most dentists and dental hygienists ever, and with three dental schools, there are roughly 300 new dentists graduating yearly.

Dentists are challenged in many ways when entering the workforce. As small-business owners, dentists must consider many factors when deciding on a location to practice. Besides having a passion of helping and serving their patients, dentists must still consider their financial obligations, whether that be loan repayment or meeting their overhead expenses. Unfortunately, with these types of decisions, some areas of the state may suffer from having a low number of dentists deciding to practice in their community.

The FDA supports proposals that promote and encourage dentists to consider these areas by receiving incentives to alleviate the financial burdens. Maximizing Florida’s existing dental workforce will allow for all Floridians to attain quality, comprehensive dental care from a highly trained dentist.

So, What’s the 4-1-1 on Dental Therapy?

Who is a dental therapist?

A dental therapist could be a high school graduate who receives three years of dental therapy training and would be authorized to perform irreversible surgical procedures, such as surgical extractions, partial root canals and administer local anesthesia under the general supervision of a dentist.

Are there CODA standards for dental therapy programs?

Yes, the Commission on Dental Accreditation (CODA) approved educational standards for dental therapy programs in 2015.

Are there any CODA-approved programs in the United States?

No, there are no CODA-approved programs in any state in the United States. The dental therapists practicing in Minnesota did not graduated from a CODA-approved program.

What states have authorized dental therapist legislation?

Alaska (dental health aide therapists), Arizona, Maine, Minnesota, Oregon (pilot project), Vermont and Washington.

Which states have dental therapists practicing?

Minnesota has about 80 dental therapists practicing and most of them are NOT practicing in rural areas. Even with dental therapists, in May 2017, Minnesota was in jeopardy of losing federal funding because it was failing to provide adequate dental care to children of low-income families.

Oregon implemented a dental health aide therapist pilot project for tribal areas and failed one of its site visits due to individuals practicing outside of their scope of practice.

Washington passed legislation specifically allowing dental therapists to practice, but only in tribal communities.

Alaska has had dental health aide therapists practicing since 2005.

Although, Arizona, Maine and Vermont have approved dental therapists’ legislation for their state, no dental therapists are licensed there because there are no CODA-approved programs in these states.

Are dental therapists the same as nurse practitioners and physician assistants?

No, dental therapists are NOT like nurse practitioners and physician assistants. Nurse practitioners and physician assistants are required to have much more education and training than dental therapists.

Does Florida have a shortage of dentists?

No, Florida does not have a shortage of dentists. Florida has approximately 14,000 licensed dentists; however, there is a maldistribution of dentists around the state, leaving the more rural areas without an adequate supply of dentists. The term “shortage” is used by some national groups to signify that people living in certain areas of the state do not have access to routine dental care. This does not mean that the state as a whole has a shortage of dentists.

Are there programs and initiatives that focus on increasing dental care in underserved areas?

Yes, the FDA has pursued reinstating the dental student loan repayment program, which incentivizes dentists to practice as full-time Medicaid providers in rural and underserved areas. In return, dentists are eligible for state assistance in repaying their student loans. This program is not a new program. Florida is one of only five states that does not have a dental student loan repayment program.

This program and other initiatives outlined in Florida’s Action for Dental Health provide a multifaceted approach to addressing issues involved with increasing access to dental care. The FDA also supports community water fluoridation and community dental health coordinators, who help patients navigate the complicated health care system.

Proponents for dental therapy will be working hard to get legislation passed in Florida. The FDA will be on the frontline for its members, educating legislators and stakeholders on the importance of Florida maintaining its high standard of care for all Floridians. Introducing dental therapists to Florida’s dental workforce does not guarantee an increase in access to dental care. Collaborative efforts are needed in oral health education and prevention. Promoting preventive dental care on the front end will provide greater benefits for everyone on the back end.

How can I help?

The FDA is looking for members who are passionate about organized dentistry’s position on dental therapy and would like to be a part of the solution to access to dental care issues in Florida.

If you would like to become more involved, please contact FDA Chief Legislative Officer Joe Anne Hart at jahart@floridadental.org or 850.350.7205.

Today's FDA - Jan/Feb 2019

Sep 4, 2024