Dental therapists, aka “mid-level providers”, are one response by American dentistry to the affordability problem and empty waiting rooms apparent since 2008. Dental therapists conduct less complex surgery and restoration, and deliver prevention too, and have cheaper hands than the dentist. They are now licensed to practice in Alaska, Minnesota and Maine, with several other states considering this initiative in various shapes and forms.
Dental therapists and independent hygienists are more widely available in Canada and the UK. In fact, these new oral health care professionals can work independently of the dentist, unlike in America where there remains oversight by the dentist.
- The therapist saw on average 6.8 patients per day.
- 90% of patients were uninsured or had public assistance.
- Surgical/restorative care involved 68% of procedures conducted by therapists.
- Dentists who had therapists took on more complex dental procedures after the therapist joined the practice. In fact, the dentist performed few restorations of dental decay and was involved in fewer preventive procedures after the therapist was hired.
So access and affordability were seemingly improved with the therapist and the dentist’s workload migrated to more lucrative procedures.
This sounds like the impact of the nurse practitioner in my own doctor’s practice.
But one caveat. The therapist saw 6.8 patients per day. It is likely that is too few patients to make a dent into the 1 in 4 American adults who need to see a dentist but can’t afford to. Dental therapists will need to improve their productivity, using new tools such as Prevora, to have any significant impact on access and affordability. They will have to deal with the cause of poor oral health (dysbiosis) not just its outcome.