Where dental therapy stands in the US

Wisconsin recently became the 14th state to authorize dental therapists to treat patients, and several other states could soon do the same. 

Dental therapists are mid-level providers permitted to provide certain services such as filling cavities and pulling teeth, but are not allowed to do more complex procedures. They must graduate from an accredited training program and work under the supervision of a dentist. 

Although dental therapists have been treating patients in more than 50 other countries for more than a century, the U.S. began adding dental therapists in 2005, according to The Advisory Committee on Training in Primary Care Medicine and Dentistry.

States began allowing dental therapists as a way to expand care and fill workforce shortages. They are also considered cost-effective roles, with reimbursement for their services being found to exceed the cost of employment. For example, a 2014 report from the Pew Charitable Trusts found that two dental therapists in Alaska who served 1,352 patients resulted in $216,000 more in reimbursement compared to their cost of employment.

In addition to Alaska, other states that allow dental therapy are Arizona, Colorado, Connecticut, Idaho, Michigan, Minnesota, Maine, New Mexico, Nevada, Oregon, Vermont and Washington, according to the American Dental Therapy Association.

Other states began considering the authorization of dental therapists last year, including New York and Massachusetts.

Although dental therapy is seen as a solution for several issues in the dental industry, some states have experienced challenges supporting this new role. 

In Oregon, licensing barriers have made it difficult for more dental therapists to practice in the state. Once the state's two pilot training programs end within the next few months, the state will have no other accredited training programs. Pacific University in Forest Grove, Ore., began developing a training program but needs $1 million in funding before it can move forward. 

Colorado's authorization of dental therapists went into effect in May 2023, but a lack of training and resources could hinder the state's ability to bring in enough of these practitioners. No schools in the state currently offer dental therapy degrees and the state does not offer a licensing exam. Trainees must receive their education in states with dental therapy programs, which only include Alaska, Minnesota and Washington. Colleen Lampron, president of AFL Enterprises, a public health contracting company, told The Colorado Sun it is unclear whether the state has enough funding to launch its own programs because current programs are already underfunded. 

The Advisory Committee on Training in Primary Care Medicine and Dentistry urged Congress and HHS in 2022 to increase funding for dental therapy training programs and create scholarship and loan repayment programs. 

"Dental therapists can play an important role in serving vulnerable and underserved populations, especially for those living in rural and other geographic areas that have a shortage of dental healthcare providers," the federal advisory committee said in its report. "Therefore, growing a dental therapy workforce supports the increase [in] access to care and [helps] improve the oral health of all Americans."

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