I consistently hear 2 fears articulated by opponents of the dental therapist (DT) concept.
1. “The quality of care that dental therapists provide will be substandard.”
2. “Dental therapists will compete with dentists and other oral healthcare providers, and threaten their bottom line.”
Both of these assumptions are completely false, and I can say that with confidence because of our experience in Minnesota, the first state to establish licensure of DTs.
High Levels of Training and Care
In the DT program at the University of Minnesota School of Dentistry, we work hard to ensure the concept of “one standard of care and one standard of education” by teaching our DT students alongside our dental and dental hygiene students. Both sets of students have the same competency requirements for graduation within their respective scopes of training. The chairside board exam in Minnesota places DT
candidates and dentist candidates side by side; the evaluators are blind as to which patients were treated by which providers. So we have a number of ways of ensuring that we are sending high-quality providers out into the community.
Complementary, Not Competitive
In Minnesota, there are currently 54 licensed dental therapists actively practicing in about 20 counties. While 58% of the DTs practice in the twin cities metro area, about a third practice in rural areas. DTs are making an impact by going to communities that are starving for oral health providers.
I recently got an email from a private practitioner who hired a DT, allowing his practice to treat more patients who otherwise wouldn’t have access to care. It lowers the cost of providing that care.
We are finding that dental therapists are definitely not a problem in terms of affecting dentists’ incomes. Many offices are hiring a second or even a third dental therapist. That speaks volumes that the DT model is not only good for delivery of care, but also beneficial for the bottom line with expanded services—otherwise, they couldn’t continue to do it.
Thankfully, it seems that the forces supporting DTs are growing stronger and more widespread, while the base against DTs is narrowing. Specifically, the National Dental Association is now actively on board, and the Commission on Dental Accreditation recently agreed to start accrediting DT programs in the U.S. This adds legitimacy to the profession—just like dental hygiene—and sets
common standards. Policymakers are beginning to understand the benefits of the DT concept as well.
Karl D. Self, MBA, DDS
Dr. Self earned his DDS degree from the University of Minnesota’s School of Dentistry in 1984 and joined its faculty in 2006. In 2010, he was selected as director of the newly created Division of Dental Therapy. During his professional career, he has been engaged in a variety of dental practice types including private practice and large group practice, yet he has spent most of his professional life in a community clinic. He has been a consultant for the Department of Human Services’ Medical Assistance program and, prior to joining the faculty of the School of Dentistry, he was Executive Director of a federally qualified healthcare center in Minneapolis.