Improving Quality Access to Dental Care

***UPDATED: December 10, 2015*** The American Dental Association (ADA) and the Academy of General Dentistry have both released statements opposing the recent approval of the accreditation process for dental therapy education programs by the Commission on Dental Accreditation (CODA). According to a recent article from The Dental Tribune, those in favor of the step believe that dental therapists will serve an important role in providing dental care access to under-served communities around the country. “These new providers are helping to address unmet oral health needs of the public and create a new career path for dental hygienists,” said Jill Rethman, RDH, BA, and American Dental Hygienists’ Association President. Other professional organizations disagree. “The ADA believes it is in the best interests of the public that only dentists diagnose dental disease and perform surgical and irreversible procedures,” the ADA said in their issued statement. The AGD replied, stating “Over the past three years, we have made it clear through testimony and written comments to CODA that the AGD has opposed the standards and their implementation. The standards require a curriculum of only three years post-high school, and then these non-dentists are able to perform surgical and irreversible procedures without requiring the direct or indirect supervision of a dentist.” AGD President W. Mark Donald, DMD, MAGD, pointed out that there is a significant lack of widespread support from both public and professional communities, seeing as only two states currently have dental therapy educational programs. The other 48 still require licensed dentist to diagnose and perform surgical procedures.

Have you heard of the “Dental Divide?” This term, coined by the American Dental Association, refers to the startling division of haves and have-nots in our country. When the ADA conducted a survey in 2013, they discovered a huge disparity between individuals who visit the dentist regularly and maintain good oral health and those who don’t, and according to the statistics, the difference was in the money. Those in a lower-income bracket are less likely to visit the dentist regularly, take more trips to the emergency room for oral pain, and are at a higher risk of  losing their natural teeth. In an effort to bridge the gap, industry players have been working towards improving oral health education and access to quality care, including allowing midlevel providers to perform preventative treatments to meet the growing need.

No one has been advocating the addition of midlevel providers nationwide more than The American Dental Hygienists’ Association (ADHA). With more than 185,000 dental hygienists licensed in the United States, many believe that there are more than enough highly trained professionals to fill the gap and improve access to quality dental care. “Dental hygienists are educated, licensed, and prepared to be a part of the solution,” claims ADHA President Kelli Swanson Jaecks, RDH. At this time, 37 states allow people to directly access oral-health care services from hygienists in at least one practice setting.

The states of Maine and Minnesota, along with the tribal lands in Alaska are addressing their access-to-care challenges with the use of dental hygiene therapists, according to a recent Dental Tribune article. These therapists provide routine preventive and restorative care to underserved populations. In California, hygienists are able to acquire advanced licenses that allow them to perform a variety of services in schools and nursing homes, including x-rays, sealants, and interim therapeutic restorations. Still others, like Oregon, Washington, New Mexico, Kansas, and Vermont, are considering how mid-level workforce proposals could work for them. “The profession of dental hygiene is on the cusp of transformation and is committed to improving access to oral health care,” Swanson Jaecks said.

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