Arizona shows how America can expand access to dental care

Communities across the United States face a growing dental care crisis. According to the U.S. Department of Health and Human Services, nearly 63 million Americans live in areas designated as Dental Health Professional Shortage Areas. Fortunately, lawmakers in Arizona recently approved a measure that promises to expand access to affordable dental care for struggling communities.

On May 16, Gov. Doug Ducey (R) signed legislation that allows mid-level dental professionals known as “dental therapists” to deliver a wide range of preventive and restorative treatments for patients in Arizona. The bill authorizes dental therapists to independently perform teeth cleanings and other important procedures, drill for cavities, and apply crowns.

{mosads}Dental therapists are already trained and credentialed to provide all these services, but most states prohibit them from serving patients unless a dentist is physically present. This legally mandated arrangement severely limits their capacity to treat families in communities that lack reliable access to dentists.

Restricting access to dental therapists is especially harmful for low-income Americans. Nearly half of all poor families failed to visit a dentist in 2017 because dental care is too expensive, is unavailable nearby, or isn’t covered by their insurance. More than 62 percent of dentists refuse to treat patients on Medicaid, which is the primary insurer for poor Americans, especially poor children.

Without reliable access to dentists, patients often visit the emergency room as their dentist of last resort. Data from the American Dental Association (ADA) show Americans make more than two million visits to the emergency room every year for preventable dental issues, such as tooth decay, which cost taxpayers nearly $700 million annually.

This dental access crisis is only getting worse.  In the coming years, increasingly more Americans will be reaching retirement age and demanding more dental treatments. At the same time, a growing number of dentists will also be reaching retirement age and hanging up their lab coats. A 2017 survey by the ADA discovered nearly four out of 10 dentists are over the age of 55 and quickly approaching retirement. 

Allowing more dental therapists to treat patients would help alleviate America’s oral health care shortages. After Minnesota became the first state to license dental therapists, the state’s Office of Rural and Primary Care found one-third of all Minnesotans experienced a reduction in wait times for dental appointments. In addition, the availability of dental therapists permitted patients in Minnesota’s rural areas to travel short distances to attain dental care.

Expanding access to dental therapists would also improve oral health. According to a report in the Journal of Public Health Dentistry, children and adults served by dental therapists receive more preventive care and need fewer invasive teeth extractions than patients who lack reliable access to dental providers.

Yet despite this overwhelmingly positive track record, some special-interest groups oppose allowing dental therapists to treat patients in need. Earlier in 2018, the South Florida District Dental Association defeated a dental therapy bill in the Sunshine State by claiming dental therapists would expose patients to substandard care. Nothing could be further from the truth.

More than 1,100 studies conducted across 26 countries demonstrate these mid-level practitioners provide patients with safe and effective care. Even the former chairman of the ADA’s Council on Scientific Affairs concluded dental therapists “are capable of providing high-quality services, including irreversible procedures such as restorative care and dental extractions.”

Rather than oppose dental therapists, dentists should welcome these mid-level providers. When dentists partner with dental therapists to deliver preventive care, dentists are free to dedicate more of their time to more complicated procedures, allowing them to earn more money. One Minnesota dentist who partnered with a dental therapist saw his profits increase by $24,000 and his patient caseloads increase by 38 percent within one year.

Dental therapists in the United States and abroad have proven they can play a crucial role in delivering quality dental care, and Arizona has now shown how the rest of the country can utilize these mid-level practitioners to improve oral health.

Charlie Katebi is a state government relations manager at The Heartland Institute, a national nonprofit, nonpartisan public policy think tank.