This claim is a scare tactic. The reality is that dental therapists take the exact same test that dentists take that covers the approximately 90 procedures they will be licensed to perform – including “irreversible surgical procedures” such as fillings and extracting severely decayed baby teeth. Fully licensed dentists can perform about 400 procedures.
In addition, dental therapists must complete a minimum of two calendar years of training (three academic years) in a program approved by the American Dental Association’s Commission on Dental Accreditation (CODA), the same organization that accredits the nation’s dental schools. They are educated to the same level of competency as dentists in both emergency management and the limited number of procedures they can perform.
The patient safety and emergency management accreditation standards for both dental therapists and dentists are extremely similar as well.
Through a signed collaborative agreement with a supervising dentist, dentists may choose to limit their dental therapist’s allowable procedures further than the proposed law permits. This is an additional safeguard similar to how hospitals may choose to limit the privileges of physicians, even though physicians are licensed to do more.
More than 1,000 studies and assessments of dental therapists in 26 countries including the U.S. demonstrate that they provide care at a level of quality equal to dentists for those procedures they have in common.1-3
Malpractice insurance rates for dental therapists in Minnesota are about $100 a year, similar to that of dental hygienists and significantly lower than that of dentists.6 These rates demonstrate that insurance companies acknowledge that the limited scope of practice of dental therapists is less of a risk than dentists’ broader scope of practice. Furthermore, as of 2018, the Minnesota Board of Dentistry has not disciplined or required corrective actions on any licensed dental therapist due to quality or safety concerns.7
Finally, the Health Services and Research Administration (HRSA) that monitors and evaluates the health workforce needs in the United States strongly endorsed the addition of dental therapy to the oral health workforce in 2022 with the educational standards proposed in the Florida legislation. Their Advisory Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD) recommended the expansion of dental therapy educational programs across the country in their 19th annual report in 2022 on dental therapy.
The American Dental Association’s own Council on Scientific Affairs conducted a systematic research review of dental therapy,8 about which the immediate past chair of this Council, in an independent report, stated, “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.”
References
- Nash, D. A., Friedman, J. W., Mathu-Muju, K. R., Robinson, P. G., Satur, J., Moffat, S., Kardos, R., Lo, E. C., Wong, A. H., Jaafar, N., van den Heuvel, J., Phantumvanit, P., Chu, E. O., Naidu, R., Naidoo, L., McKenzie, I., & Fernando, E. (2014). A review of the global literature on dental therapists. Community dentistry and oral epidemiology, 42(1), 1–10. https://doi.org/10.1111/cdoe.12052
- Minnesota Department of Health, Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota: Report to the Legislature, 2014,” February 2014; https://mn.gov/boards/assets/2014DentalTherapistReport_tcm21-45970.pdf
- Wetterhall, S. et. Al, “Evaluation of the Dental Health Aide Therapist Workforce Model in Alaska: Final Report,” October 2010, https://www.rti.org/sites/default/files/resources/alaskadhatprogramevaluationfinal102510.pdf
- Kenneth Anthony Bolin, “Assessment of Treatment Provided by Dental Health Aide Therapists in Alaska,” Journal of the American Dental Association 139, no. 11: 1530, doi: https://doi.org/10.14219/jada.archive.2008.0080;
- Gordon Trueblood, “A Quality Evaluation of Specific Dental Services Provided by Canadian Dental Therapists,” Ottawa, Ontario, Canada: Epidemiology and Community Health Specialties, Health and Welfare Canada, 1992.
- “Dental Therapy in Minnesota: A Study of Quality and Efficiency Outcomes,” Presentation by Sarah Wovcha, Executive Director, Children’s Dental Services, https://slideplayer.com/slide/11737163/.
- The Minnesota Department of Health and the Minnesota Board of Dentistry, “Dental Therapy in Minnesota, Issue Brief, 2018,” https://www.health.state.mn.us/data/workforce/oral/docs/2018dtb.pdf.
- Wright J. T. (2013). Do midlevel providers improve the population’s oral health? Journal of the American Dental Association (1939), 144(1), 92–94. https://doi.org/10.14219/jada.archive.2013.0018
- Dental Therapy Education Program Accreditation Standards https://coda.ada.org/-/media/project/ada-organization/ada/coda/files/dental_therapy_standards.pdf?rev=814980f6110140e7ba00659703cc3b3c&hash=81A3585FD5B1B478DA7D99065A9B75DE
- Dental Education Program Accreditation Standards: https://coda.ada.org/-/media/project/ada-organization/ada/coda/files/predoc_standards.pdf?rev=20eabc229d4c4c24a2df5f65c5ea62c8&hash=B812B8A2FAF6D99F37703EE081B48E58