Dental therapists could help end shortage of dentists to meet need

People of all ages in the Puget Sound region should be able to find quality dental care that lets them work, go to school and avoid dental pain. Yet here and across the state, many of them can’t. In any given year, about half of all the state’s children and insured adults do not receive dental care. It is even worse with low-income adults insured under Apple Health (Washington’s name for Medicaid) where four out of five can’t find a dentist.

Why? There are not enough dental providers for these people.

A dental therapist can add another oral health care provider to the workforce and modernize the dental team to put affordable care within reach of more people. The state Legislature can make this happen. Unfortunately, some in the dental care community prefer to stand in the way of allowing this change to occur.

And the consequences can be tragic. Steve McNall would still be with us if he had received consistent, affordable oral health care. Steve, who resided in Lacey, came to a local clinic with an acute dental abscess that needed hospital attention. Afraid of a medical debt he could not afford to pay, he went home to rest instead. His mother found him dead later that day.

As horrifying as Mr. McNall’s death is, it was not an isolated incident. A 2013 study published in the Journal of Endodontics found that between 2000 and 2008, the number of people hospitalized for dental abscesses increased by more than 40 percent from about 5,700 in 2000 to more than 8,100 in 2008. Of the 61,439 hospitalized during that time, 66 patients died in hospital.

The solution proposed by other dentists is to have a day of charity where they donate their time to do dentistry for the underserved. While charity is laudable, we cannot volunteer our way out of this problem. It is the ambulance at the bottom of the cliff. Dental therapists are the fence at the top of the cliff. They provide access to the basic services that provide protection against lost days of work, loss of teeth and loss of life.

Dental therapists currently practice in Minnesota and Alaska; studies on their economic viability have found that they cost their employers 30 cents to every dollar of return. Children’s Dental Services, a safety net dental provider in Minnesota, reports that each dental therapist on staff saves the clinic $1,200 a week and consequently has allowed them to hire more people and provide more dental care to uninsured patients and those covered by Medicaid.

We can no longer imagine the medical profession without midwives, physician assistants or nurse practitioners; in the field of dentistry, we need to incorporate the same innovations to maintain healthy families and create strong communities. I challenge my colleagues and the public to get involved and encourage every state legislator to enact legislation allowing us to integrate dental therapists into our dental team.