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OUR OPINION: Does N.D. need dental therapists? Study will find out

Not exactly under the radar, but maybe under the dental X-ray machine, legislation advanced in Bismarck this week that could dramatically change and possibly improve access to dental care in North Dakota.

Our Opinion

Not exactly under the radar, but maybe under the dental X-ray machine, legislation advanced in Bismarck this week that could dramatically change and possibly improve access to dental care in North Dakota.

The word "possibly" is the key. And that's exactly what will be at issue over the next two years, assuming the governor signs House Bill 1454, which has passed both houses.

The bill authorizes a study of dental-care access, with results to be presented to the 2015 legislative session. And a key goal is to examine "the use of mid-level providers" -- namely, dental therapists, whose licensing has been pioneered by Minnesota and now is being examined by other states.

Kudos to the lawmakers for taking this step. The study may conclude North Dakota doesn't need the new mid-level professionals; more about that below.

But around the country, low-income people -- especially children -- by the millions lack access to dental care, with serious health and lifetime appearance consequences. How bad is the problem in North Dakota, and might dental therapists help solve it?


That's the issue the legislative study will and should take up.

Dental therapists are midlevel professionals who "span the divide between the hygienist and the dentist, much like a nurse practitioner or physician assistant," the Star Tribune reported last month.

Minnesota began licensing the practitioners in 2009. Today, the state has about 25 dental therapists; their licenses let them drill-and-fill cavities and administer Novocaine and nitrous oxide, but not perform root canals or fully sedate patients.

"Minnesota is definitely a pioneer and constantly referenced in other states," said Julie Stitzel, campaign manager for the Pew Children's Dental Campaign, to the Star Tribune. The Pew campaign strongly supports the licensing of dental therapists, in part because so many low-income children lack dental care.

"Dental care is the greatest unmet need among children," the Pew website declares.

"In 2009, more than 16 million low-income children went without care. Tooth decay affects nearly 60 percent of kids. If untreated, the consequences can be painful and disruptive to learning and daily activities. In extreme cases, untreated decay can lead to serious, potentially life-threatening infections."

In Maryland in 2007, a five-year-old boy from a poor family died when bacteria from an untreated tooth infection spread to his brain.

But North Dakota's situation isn't as dire, Pew suggests. In 2011, the state earned a B on Pew's Children's Dental Health report card; it was one of 27 states to get an A or a B.


And in January, North Dakota was one of only five states to get an A on an updated Pew report, which looked at children's access to dental sealants.

One reason for the good scores: Volunteer clinics in Grand Forks and elsewhere, which see patients who otherwise wouldn't get dental care.

Such programs have made North Dakota a national model, suggests Dr. Brent Holman, a Fargo pediatric dentist. And "my concern is that this discussion (about dental therapists) will distract from our nationally known success in building partnerships to solve access problems," Holman wrote in a recent web posting.

Are the partnerships enough? Are the trends moving in the right direction? And how do North Dakota and Minnesota's experiences compare?

North Dakotans should be grateful to their lawmakers, who've not only asked those key questions but also resolved to get answers.

Related Topics: HEALTHCARE
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