This week, PBS’ NewsHour highlighted that millions of Americans go without dental care and also profiled how alternative dental providers, known as dental therapists, have improved access to care in Alaska and have the potential to do the same in the lower 48.
The first report in the series highlights that millions of Americans go without regular dental care. According to the report, only one of every two Americans has dental insurance, which means cost is a barrier to getting care for too many Americans. The report also detailed that Americans, particularly those in rural or low-income communities, often have trouble finding dentists who will serve them - more than 50 million children and adults in the United States live in areas without enough dentists.
Unfortunately, not having dental care can have serious effects on your overall health. Due to poor access to dental care, tooth decay is the most common chronic childhood disease in the United States – five times more common than asthma. Left untreated, dental decay can set the stage for a lifetime of poor health. It is linked to such serious health problems as diabetes, stroke and heart disease.
In part two of the NewsHour series, the report highlighted how dental therapists are being used in Alaska to treat previously underserved Alaska Natives. The piece highlights how dental therapists are bringing care to 35,000 people who never had access to regular dental care before.
Dental therapists are effective in reaching previously underserved populations because they are able to deliver care in the community, which is more efficient and effective than relying on patients to travel far distances to see a dentist in a traditional dental home.
Also, dental therapists can provide preventive care and commonly needed services such as fillings and routine extractions. That way, dentists can see more patients, and midlevel providers can expand access further by practicing in remote areas where there are no dentists.
The dental therapist program in Alaska has worked so well that it is seen as an innovative way to better deliver care to the 83 million Americans going without regular dental care because there are not enough affordable providers in their community or there are no providers in their community to serve them.
In addition the dental therapists practicing in Alaska, dental therapists are already authorized and being trained in Minnesota. Alternative providers such as dental therapists are under consideration in 16 other states. Community Catalyst is working with the W. K. Kellogg Foundation to support the establishment of a new primary care dental provider in Kansas, New Mexico, Ohio, Vermont and Washington. The Pew Charitable Trusts is working on similar efforts in multiple states as well.
Momentum is growing based on the model’s history of success. Last month, the Kansas City Star endorsed the effort led by Kansas Action for Children, Kansas Association for the Medically Underserved and Kansas Health Consumer Coalition to establish a registered dental practitioner position. The registered dental practitioner would be able to provide routine and preventive care to underserved residents of the state - 93 of 105 Kansas counties do not have enough dentists and only 25 percent of Kansas dentists accept Medicaid patients. Registered dental practitioners could fill this void by helping dentists extend their reach into underserved communities and giving dentists who treat underserved populations an additional provider to help them see more patients.
As the Kansas City Star noted, Kansas has a chance to get out in front of a healthy trend. Lawmakers should get to work on a sound bill that enables well-trained clinicians to serve the basic dental needs of Kansas citizens.
There is significant research supporting the efficacy of dental therapists in increasing access to care and delivering quality care. Still, the ADA and organized dentistry, such as the Kansas Dental Association oppose this proven model despite admitting they have no evidence to support their position. In the Kansas City Star, Kevin Robertson, the Kansas Dental Association’s executive director, acknowledged that no research backs up the association’s contention that dental practitioners could compromise patient safety. The ADA’s President, Dr. William Calnon, made similar statements in the NewsHour report.
As one in five children suffer because they are unable to access regular dental care, we must move beyond turf fights and advocate for policies and providers such as dental therapists that can help improve access to care and the health of patients and communities. We have a real opportunity to place providers in communities where no one is available to offer care, which means less decay, fewer health problems, and lower health care costs. As you watch the NewsHour piece, envision how dental therapists could help better deliver care to your community, and please use Community Catalyst as a resource.
-- David Jordan, Dental Access Project Director