Dental therapist controversy rises

While dental organizations warn that patient safety is at stake, California and other states are exploring dental therapy models to expand the dental workforce and to address the problem of people going without oral healthcare.

In 2005, Alaska became the first state to try out the new dental care model, when therapists began treating native populations. In 2009, Minnesota Governor Tim Pawlenty signed into law the Dental Therapist Legislation, which provides two levels of providers. A dental therapist requires a bachelor's degree, and an advanced dental therapist requires a master's degree. Many advanced dental therapists may work in community settings under general supervision of a licensed dentist.

In a recent LA Times article, The American Dental Association argued that dental therapists lack the training and education needed to perform irreversible surgical procedures and to identify patients' other medical problems.

ADA President Bill Calnon is quoted saying, "This is not about dentistry or dentists protecting dentists." "This is about dentists doing what they feel is the absolute best for the American public … and doing it in a way that maintains the highest level of quality care possible."

But advocates and researchers counter that concerns about insufficient training and substandard quality are unfounded.

Therapists would be properly educated and would help close vast gaps in care that can lead to costly emergency room visits for dental problems, said Shelly Gehshan, director of the Children's Dental Campaign for the Pew Center on the States. Nationwide, 830,000 emergency room visits in 2009 were due to preventable dental problems, according to the center.

According to Suzanne Beatty, a dentist and curriculum coordinator at Metroplitan State for the Master's program, dental therapists free up the dentist to do more complex procedures.

"It's not an independent practice," said Beatty. "It's part of a collaboration."