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Editorial: Expand coverage with dental therapists in North Dakota

We've heard the arguments about the proposal to license dental therapists as mid-level practitioners in North Dakota.

Now, let's hear the evidence:

▇ "Though nearly two dozen studies from industrialized countries address this subject (of dental therapists' technical competence), this article systematically reviews all 23 of them.

"Of these reports, all but two conclude that dental therapists perform at an acceptable level. "Every study that directly compared the work of dental therapists with that of dentists found that they performed at least as well. ...

"Rarely in the scientific literature, in fact, do we find such an overwhelming consensus based on empirical research."

-- E. Phillips and H.L. Schaefer, Journal of Dental Research, July 2013

▇ "The purpose of this study was to obtain baseline knowledge of dental therapists' practice patterns in Minnesota and determine if dentists' patterns of work changed after a dental therapist was employed.

"Four dental practices were sampled. ... Dental therapists saw up to 90 percent of uninsured patients or patients on public assistance. ... Dentists delegated a full range of procedures within the dental therapy scope of practice, indicating trust and acceptance of dental therapists. ...

"Conclusion: Dental therapists are treating a high number of uninsured and underinsured patients, suggesting that they are expanding access to dental care in rural and metropolitan areas of Minnesota."

-- Christine Blue and Mary Beth Kaylor, Community Dentistry and Oral Epidemiology, April 2016

▇ "While midlevel providers are new to the U.S. dental profession, medicine has utilized these positions for years. ... Studies of midlevel dental providers suggest potential practice and public health benefits.

"With appropriate training, licensure, supervision, and deployment to geographical areas of significant need, we believe midlevel dental providers could increase access to care to underserved populations and help in the prevention of deaths attributable to untreated dental disease."

-- Tobias Rodriguez and others, Journal of Health Care for the Poor and Underserved, May 2013

▇ "Conclusions: The dental therapy workforce is growing and appears to be fulfilling statutory intent by serving predominantly low-income, uninsured and underserved patients.

"Dental therapists appear to be practicing safely, and clinics report improved quality and high patient satisfaction with dental therapist services.

"Clinics employing dental therapists are seeing more new patients, and most of these patients are public program enrollees or from underserved communities.

"Dental therapists have made it possible for clinics to decrease travel time and wait times for some patients, increasing access. ...

"Savings from the lower costs of dental therapists are making it more possible for clinics to expand capacity to see public program and underserved patients."

-- Minnesota Board of Dentistry and Department of Health Report to the Legislature, February 2014

The evidence is in, and it's almost entirely in dental therapists' favor. The Legislature should allow the therapists' licensure as a safe, innovative and cost-effective way to expand North Dakota's health care workforce.

-- Tom Dennis for the Herald

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