Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations

Abstract

The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21 Century."

Educational Models for the Re‐Establishment of Dental Therapy Education in Canada

“…Combining dental therapy and dental hygiene curricula has been an international trend 14,16,33 since the 1990s and is evident in Australia, 34 New Zealand, 35 United Kingdom, 36 and the Netherlands. 37 According to Nash, the graduates of such programs are increasingly referred to as "oral health therapists" (OHTs).…”

“…More than 50 countries have integrated providers with dental therapy abilities, 14 and their positive impact on access to safe, cost-efective oral services is well documented. [14][15][16][17][18][19] According to Phillips and Shafer, "Rather than representing a diferent standard of care, dental therapists simply represent a diferent provider." 18 Recent studies have found that many oral health needs of populations that are underserved could be met by providers with a combination of dental hygiene and dental therapy abilities.…”

“…18 Recent studies have found that many oral health needs of populations that are underserved could be met by providers with a combination of dental hygiene and dental therapy abilities. 16,[19][20][21][22][23] Wanyonyi et al reported that 73% of the services provided in England's state-funded clinics in 2011 to 2012 were services within the scope of dental hygienists and dental therapists. 20 Their modeling suggested that employing more such providers would result in a 52% salary saving in the oral health sector.…”

Estimating the Number of Dentists Needed in 2040

“…If Medicaid-enrolled adults below 250% of the Federal Poverty Level were provided with basic dental benefits, it would certainly increase utilization rates, at least initially. 25 Nevertheless, such legislation is periodically being introduced in other states, suggesting that this could change. Thus, greater demand from low-income adults would likely be well within the capacity of the current care system.…”

“…Few other states have legalized the use of dental therapists, and it would take many years before a large enough number of dental therapists is available to make a significant difference. 25 Nevertheless, such legislation is periodically being introduced in other states, suggesting that this could change. On the other hand, dental hygienists in many states are providing screening and primary and second-ary preventive services to children in school-based delivery systems and in private practices.…”