« July 2016 Issue

Vermont Is the Latest State to Green Light Dental Therapy

At a ceremony on June 20, 2016, Vermont Governor Peter Shumlin signed into law legislation making the Green Mountain state the fourth in the country to establish the practice of dental therapy. The addition of dental therapists to dental teams helps to eliminate the oral health inequities in a broken U.S. dental care system that leaves tens of millions without access to quality affordable oral health care.

Enactment of the Vermont Dental Therapy law is a significant win for Community Catalyst’s Dental Access Project and our advocate partners, Voices for Vermont’s Children, who have worked on the issue for more than five years. The group, and the Oral Health Care Coalition it led, generated more than 200 personal stories, 1,500 petition signatures and countless phone calls, letters and meetings in support of this proven provider in the face of fierce opposition by the powerful and heavily resourced dental lobby.

“The Vermont law is a monumental step forward and helps build momentum for dental therapy as a cost-effective approach to expanding access to dental care to all people, in all areas of the country,” said Tera Bianchi, director of the Dental Access Project. “It also underscores the critical role local advocates played in this victory, galvanizing thousands of community members and more than 40 state organizations and taking on formidable special interests to help make this happen.”

The American Dental Association opposes dental therapy and has used its clout to block dental therapy legislation from moving forward in numerous states, including Vermont. The dental lobby tactics are similar to those once employed by some physician groups to prevent nurse practitioners and physician assistants from becoming health care providers.

Dental therapists operate similarly to nurse practitioners and physician assistants in medicine, working with dentists and dental hygienists as part of a dental team. They provide routine and preventive care under the general supervision of a dentist, either on or off-site. This innovative, team-based approach enables dental practices to increase the number of people they can serve in a cost-efficient and patient-focused manner.

The scope of the oral health crisis in the United States is staggering. Each year, millions of Americans go without regular dental visits and more than four out of ten children go without regular dental care. In Vermont, tens of thousands of residents go without needed dental care every year, including almost 40 percent of children with Medicaid coverage, because they can’t afford dental care or find a dentist that accepts their insurance.

“It is unacceptable that 181 million Americans go without a dental visit each year, either because they can’t afford the care, can’t find a dentist willing to take Medicaid coverage or they live in an area where dentists don’t practice,” said Bianchi. “This law will allow Vermonters greater access to critically-needed routine and preventive dental care that will improve health in the state.”

The Dental Access Project, a joint initiative between Community Catalyst and the W.K. Kellogg Foundation, works in five states – Kansas, New Mexico, Ohio, Vermont and Washington – to empower state advocacy and community groups to expand access to dental care through dental therapy. In addition to providing consumer and community groups in these states with strategic guidance, the Project played an active role advocating for dental therapy standards, which were adopted last year by the Commission on Dental Accreditation (CODA).

In the past year alone, nearly a dozen states and tribes have pursued adding dental therapists to dental teams to help solve deep oral health disparities and severe unmet dental needs. Dental therapists currently practice in Minnesota and on tribal land in Alaska and Washington. They are authorized to practice in Maine and will soon be practicing in Oregon under a statewide pilot program. In May, the Massachusetts State Senate passed legislation to allow dental therapy.

For Bianchi, who joined Community Catalyst in 2014 from Washington State’s Children’s Alliance where she led the Dental Access Project work, the Vermont victory is particularly gratifying.

“It’s great to see this issue getting a lot of traction across the country thanks to the investment of the W.K. Kellogg Foundation and hard work on the ground at the community level,” said Bianchi, adding that philanthropies such as Pew Charitable Trusts and other foundations have also supported the dental therapy movement nationally. “We are really buoyed by the success we had in Vermont and progress in Maine, Washington, Oregon and now Massachusetts. We encourage other states to follow their lead and allow for dental therapists to become part of dental team.”

Kathy Melley, Director of Communications