Oral health leaders have been battling for and against certain initiatives in the interest of preserving best practices and preventing changes that could negatively impact patient care and practice operations.
Here are five recent controversies affecting the dental industry:
H-1B visas
Dental organizations have pushed back against an executive order they say could threaten dental staffing in the U.S., but new legislation could expand those threats permanently.
The Trump administration imposed a $100,000 fee for each new H-1B visa application in September, up from the $3,500 fee previously required of employers. Healthcare groups spoke out against the imposed fees last year, warning that such requirements could exacerbate workforce shortages and reduce access to care. Although the White House has previously indicated it could consider exemptions for certain healthcare workers if their hiring is deemed in the “national interest,” there have been no public reports of such exemptions being made.
While seeking clarification on the new fees in October, the ADA noted that 13% of dental faculty in the U.S. received their dental degree outside the country. Six percent of dental faculty also identified as nonresident aliens in 2022, according to a survey by the American Dental Education Association, but that percentage could actually be higher due to nearly 25% of respondents not disclosing their legal status.
On Feb. 9, U.S. Rep. Greg Steube, R-Fla., introduced legislation to end the H-1B visa program altogether.
Rep. Steube said in a news release that the H-1B visa program has disadvantaged U.S. employees through the prevention of physicians accessing residency programs and the displacement and layoffs of employees working for various companies.
Virginia workforce bills
Dentists and hygienists in Virginia are debating a pair of bills aimed at reducing workforce shortages.
SB178 would allow dental assistants to earn certification as a preventive dental assistant, with authorization to perform certain services and duties under dentist supervision, including placing and finishing restoration materials, taking impressions and removing cement from crowns. SB282 would create a licensure pathway for internationally educated dentists to become hygienists.
While several dentists support the bills as a way for offices to see more patients and alleviate workforce pressures, hygienists are opposing the bills due to potential risks of patient harm.
Minnesota dental therapy proposal
The Academy of General Dentistry and the Minnesota Academy of General Dentistry recently raised concerns with the Minnesota Board of Dentistry about a proposal to expand the scope of practice for dental therapists.
One proposed change would allow dental therapists to place and remove sutures, instead of only removing sutures. Another would allow dental therapists to manage surgical complications.
The AGD and the MAGD said the first proposal could lead to compromised healing, excessive bleeding, tissue damage, and the need for corrective treatment for patients. The organizations also said the second proposal requires advanced clinical judgment and training.
California orthodontic assistant proposal
The Dental Board of California paused its consideration of changes to orthodontic assistant training after opposition from several organizations.
The California dental board was considering moving orthodontic assistant education away from in-office training to an external accreditation model. The AAO and CAO worked together to highlight the importance of preserving in-office training for orthodontic assistants and avoiding additional barriers to the field. The California Dental Association also argued that the change could impose barriers to education without a demonstrated benefit to patient care.
The state dental board was scheduled to discuss the proposal in November but decided not to move forward with it due to a lack of stakeholder consensus.
Florida dental therapy bill
The Florida House of Representatives has passed a bill authorizing the creation of dental therapists in the state amid division over the practice among dental leaders.
House Bill 363 allows dental therapists to administer local anesthesia and nitrous oxide, as well as complete nonsurgical tooth extractions.
Dental therapists in Florida would have to graduate from a dental therapy school or a college accredited by the Commission on Dental Accreditation, be at least 18 years old and have a clean criminal background. The Department of Health and Board of Dentistry would also regulate and license dental therapists in the state.
Dental therapy has been a controversial issue in the state for the last several years. The Florida Dental Association has historically opposed dental therapy, citing concerns about quality of care and the cost of creating a certification program. However, other organizations such as Floridians for Dental Access, the American Children’s Campaign and the Florida Dental Hygienists’ Association support dental therapy as a way to increase access.
Previous efforts to pass a dental therapy bill in the state have failed, including a bill filed during last year’s legislative session.
