The Battle Over Dental Therapist Role Heats Up

February 3, 2017
Sarah Handzel, BSN, RN

Arizona is the latest state to look to expand the role of dental therapists. According to a report from azcentral.com, the state legislature has stalled in its attempts to expand the scope of practice for these dental professionals.

Dental therapists, considered mid-level providers, are already allowed to practice dentistry in several states, including Minnesota, Maine and Vermont. They operate under the supervision of a licensed dentist and can perform a variety of minor dental procedures, such as placing crowns, providing fillings, and performing tooth extractions.

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However, many dentists and lawmakers are not receptive to this type of dental practitioner. In Arizona, the battle is heating up over changes to the scope of practice for dental therapists. According to a report from azcentral.com, the state legislature has stalled in its attempts to expand the scope of practice for these dental professionals.

Many dentists in the state have raised strong objections to allowing dental therapists room to practice independently, even though the state is in desperate need of more dental providers to help address the growing need for care. This is especially evident among low-income, rural and tribal communities.

In December 2016, Dental Care for AZ, a pro-dental-therapy group, submitted an application to the state legislature’s Committee of Reference, seeking approval for an expanded scope of practice for dental therapists in the state. The application was rejected in a hearing that included dentists and lawmakers, many of whom questioned the dental therapists’ training in addition to the need for new providers.

Rep. Regina Cobb, a committee member and dentist, said that allowing dental therapists to practice without the supervision of a licensed dentist should be cause for concern.

“That is the problem ... they (therapists) don't know what they don't know.” She said that, if dental therapists were allowed to perform more complicated procedures like tooth extractions, it might lead to major complications like perforated sinus cavities or broken root tips. She said, if “you did this to a child, you now have created a dental cripple for life. The protection of children is my concern.”

Even though this measure was rejected, proponents of an expanded dental therapist role plan to continue to push for a place in Arizona’s dental care network. An independent report from Delta Dental of Arizona Foundation indicated a clear need for more access to dental care, since approximately one-third of the state’s population lives in a dental provider shortage area. According to the report, these people do not have regular access to dental care, and frequently use hospital emergency departments as their only option for dental care.

In response to the independent report, the Arizona Dental Association has said that the problem is not that there are too few dentists, but rather that dentists are not distributed evenly across the state. Instead of expanding the role of dental therapists, the Association instead favors options like teledentistry as a way to bring access to care to more rural communities.

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