***UPDATED: April 5, 2013*** Access to dental care still remains a problem across the United States, and it’s contributing to a growing epidemic of oral disease throughout the nation. According to a recent AP report out of Topeka, Kansas, the House and Senate are sitting on bills that could potentially help improve access however. The controversial bills involve allowing midlevel dental providers to perform approximately 30 basic dental procedures, including “nonsurgical extractions” of diseased permanent teeth. Providers would be licensed dental hygienists who have passed a clinical exam, practiced for at least 500 hours under the supervision of a dentist, and who are protected by liability insurance. Several state and national dental associations have spoken against allowing midlevel providers to practice for fear of safety and the creation of two levels of care. It appears that for now, the concept will remain just that, an idea that has yet to come to fruition.
Access to dental care in America was the focus recently on PBS’s “Frontline,” when a program titled “Dollars and Dentists” aired a few days ago. In a joint effort with the Center for Public Integrity, the network attempted to reach the masses and raise awareness of the growing epidemic of oral disease in our country. Shortly after the program was aired, the American Dental Association (ADA) released a statement in response to the report that was published on their official website.
ADA President, William Calnon, contributed to the program with a lengthy interview recorded back in January. Segments were used in the show, where Calnon focused primarily on the importance of shifting the nation’s views on dentistry away from intervention and toward preventative care. And while the reputable association supports the overall message of the program, there were some issues that the ADA felt needed to be addressed in a formal statement. The “Frontline” program spent significant time discussing the debate about allowing “dental therapists” to perform surgical procedures. These therapists undergo as little as 18 months of post-high school training, which is where the association takes issue, as they do not believe this is adequate preparation for such practices, which include extractions and pulpotomies, or the drilling through the hard tooth surface to remove soft tissue. They are also concerned about a segment that focused on Medicaid fraud and abuse, which they fear may cause negative impressions of dentists who treat Medicaid participants. Many of these dentists treat these patients for little, if any revenue, and do so out of a commitment to provide care for all people, especially those whose financial situations may prevent quality care. While there are certainly few imposters who abuse the system for personal monetary gains, there are also thousands of honest, hardworking professionals who don’t.
There is no doubt that access to dental care is a huge issue in our country. It is estimated that 1 in 3 Americans does not receive the oral care they need due to a number of limiting factors, including geography, culture, language, poverty, and according to the ADA, a societal failure to value oral health. In order to truly solve the dental crisis, all of these variables need to be addressed. The ADA statement claims that “the country will never drill, fill, and extract its way to victory over untreated dental disease.” Instead of focusing on investing in dental therapists or cracking down on Medicaid fraud, increasing oral health education and disease prevention is the key to stopping this epidemic from continuing to spread across America.