The dental therapist debate revisited

The concept of dental therapists has once again stolen the national spotlight in terms of health care reform. This week, The New York Times published an opinion piece by Dr. Louis Sullivan, former secretary of the Department of Health and Human Services, stating the need for dental therapists to solve the national barrier to dental care problem. Dr. Sullivan claims that “little is being done” both by the government and the dental profession to prepare for the outcomes of the Affordable Care Act. He admits the government “can and should train more dentists,” but this process would be too lengthy and dental therapists would be an alternative to care.

Though truth lies in Dr. Sullivan’s comments regarding barriers to care, it is important to note the ADA stance still remains that only a dentist should perform irreversible procedures. Just yesterday, the W.K. Kellogg Foundation issued a report reviewing the practice and history of dental therapists in 54 countries. As noted in the report, a typical dental therapist has a mere two year training after high school prior to performing procedures dental students spent four years of post-graduate education perfecting.

Following the release of this report, the American Dental Association offered observations and a strong stance against the lack of evidence in this report. The ADA mentions their own goals in regards to relieving barriers to care do match up with those of the Kellogg foundation, but this one solution “appears to be a 460-page advocacy document intended to support a predetermined conclusion.” The most notable critique by the ADA is the lack of documentation provided by over half of the countries said to utilize dental therapists and the absence of consistency among dental therapist systems worldwide.

Contrary to Dr. Sullivan’s claims, the ADA has devoted millions of dollars to develop curriculum for Community Dental Health Coordinators to work in underserved areas in order to provide education and preventative services to these populations (source). Underserved populations contain some of the most medically complex patients that demand the highest trained practitioners with the most training. As a student, the value of my education is on the line. Though I’m fortunate enough to attend school in Texas, some of my colleagues spend over $200,000 in tuition alone (excluding 4 or 5 years of undergrad) to obtain a high level of education known to be effective since well before the days of G.V. Black. To have the government devalue the time, money and effort spent to obtain a Doctorate of Dental Surgery (or Dental Medicine) is to deprive the public of the best oral health care possible.

~Katie Sowa, Houston ’15, electronic editor


Comments (4)

  1. Mary Williard, DDS

    Katie,
    I have yet to see anywhere the W.K. Kellogg Foundation, the government or any other entity “devaluing” your education. The dental therapist model relies on well educated dentists to supervise and lead a care team in providing a wide range of services. Having a dental therapist on our teams will actually require dentists to become better physicians of oral health because they will regulate the routine care and preventive services to the therapists, allowing the dentists to focus on providing the higher level services that are out of the therapist’s scope of practice. The dentist of the future needs to have the ability to manage complex patients and a team of providers.
    The other reality that you have not recognized is that having a dental therapist on your team will mean more work for dentists. Your patients will be engaged by both the therapists and hygienists to increase their oral health literacy, thus increasing the demand for higher levels of care. It is also true that having more providers looking in mouths, espcially if those are the mouths of people who have not had a dental home before, will lead to more documented needs.
    In short, the point I am trying to make is that dentists will be more valuable than ever when dental therapists become a part of the team. G.V. Black was a visionary, and a lot of time has passed since he made his observations. Staying stuck in the past is not how we progress. Please look at the information in Dr. Nash’s review of the literature, look at our Alaska DHAT, keep an open mind and try not to shut the door on a much more rewarding and exciting future for yourself.
    Respectfully,
    Mary Williard, DDS
    DHAT Educational Program Director
    Alaska Native Tribal Health Consortium

    Reply
  2. Jennifer

    This might be the dumbest thing I’ve ever read. Usually students have good insight into upcoming health matters, but this my dear is certainly not the case.

    Reply
    • afshan

      why don’t you explain yourself before you just make a random blanket statement about an article somebody spent the time to write. put some effort into formulating some sort of argument rather than just saying that it’s dumb. your comment is the worst sort, its basically trolling.

  3. Chris

    Thanks for the article. The need for more health care providers is, indeed, there, Dental Therapists inclusive. However, for one to complete 2 yrs after high school and do a filling is a slap in the face for DDS and DMDs. The training period for a Dental Therapist ought to be increased or reduced the training required to obtain a DDS degree. Also, if a Therapist works under a DDS, doesn’t that dentist required to be onsite in the underserved communities?

    Reply

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