Dental therapists: could this be the key to bridging the gap in oral health disparities
OA Version
Citation
Abstract
As of 2014, more than 45 million Americans live in an area considered a “dental health professional shortage area”, dental HPSA, which is an area lacking an adequate number of dentists needed to serve the population (Garcia& Kelley, 2014); and as of March 2021, 61.47% of HPSAs were located in rural areas (Rural Healthcare Info Hub (RHI Hub), n.d). One of the main reasons contributing to the occurrence of dental HPSAs is the fact that graduating dental students are unwilling to work in urban or rural underserved areas because of the location and low reimbursement rates from Medicaid (HPSAs, 2014). On average, Medicaid pays dental providers significantly lower than what the provider would receive from those individuals who are privately insured of uninsured (Borchgevink et al., 2008). There is an evident need for more dental providers in these rural areas, but if dentists are less inclined to work in such areas, how can this shortage and poor access be addressed? This is where dental therapists (DTs) come into play. Although the available body of facts on improvements in access to dental care restricted to the states that have implemented DTs, the results have been positive
nonetheless, especially in Alaskan tribal communities as well as Minnesota. In 2011, the Alaskan dental therapists were evaluated on their clinical technical performance and the results indicated that they were performing at an acceptable level during the two years the evaluation was being conducted. The DTs were also evaluated on criteria like the criteria applied in dentists’ licensing exams; the therapists’ composite preparations had no discrepancies and only two of their amalgam restorations had discrepancies in retention, however, retention discrepancies are not “critical errors” based on the evaluation criteria (Bader et al., 2011). To date, research, as it pertains to DTs, has been focused on technical competencies and found the level of care rendered by a DT to be of equal satisfaction to that of a dentist (Phillips & Shaefer, 2013). Meeting the challenges of reducing disparities in access to oral healthcare in the
U.S. does not have one simple fix. Because of this, it is important for states to direct their resources to preventative services rather than spend excessive amounts of money on palliative emergency services. States should begin to heavily consider this mid-level provider as a remedy to this problem. The research that has been gathered on Dental Therapists, Advanced Dental Therapists, Dental Health Aide Therapists, Dental Nurses, etc., has a promising outlook; the U.S. should look to states such as Minnesota and Alaska to model their own states legislation for DTs.