Mid-Level Dental Providers Gather Steam

With more untreated tooth decay and periodontal disease than any other population group, the state of oral health among American Indians and Alaska Natives is simply unacceptable, according to Pam Johnson, oral health project specialist with the Northwest Portland Area Indian Health Board.

Especially for children, she said. “Too many live in pain, miss school and, in extreme cases, risk life-threatening infections because there are not enough dentists where they live or because they cannot afford dental care:”

The current dental workforce is inadequate. Indian Country has, on average, about half the dentist-to-population ratio of the national average, and about one-fifth of the dental positions within the Indian Health Service are vacant, she added.

Tribal communities need the reliable, culturally competent care that dental health aide therapists can offer, Johnson said. Since therapists came into the picture, 40,000 Native Alaskans have access to regular dental care for the first time. Dental therapists were first introduced to the United States over 10 years ago by a consortium of Alaska Native tribal health organizations.

Johnson’s thoughts were echoed recently by Wendell Potter, a whistleblower and former health insurance executive, who wrote, in a recent article in theHuffington Post, that community-led efforts to rely on mid-level dental providers in underserved areas has fallen on deaf ears after being stymied by organized dentistry. More than 130 million Americans lack dental coverage.

This cause has brought a conservative voice to the table. Grover Norquist, founder of Americans for Tax Reform, which favors limited government, believes it’s time to expand the dental workforce.

When Potter asked Norquist why he joined this fight, “He told me it’s because in his view, opponents are engaging in tactics to preserve a profitable status quo at the expense of millions of Americans. To him, this smacks of ‘crony capitalism’ in which businesses and professionals exert influence on government officials usually through campaign contributions and lobbyists to get favorable treatment.”

Norquist is encouraging state officials from across the country to “tear down an unnecessary government barrier that prevents mid-level providers from offering dental services at no cost to taxpayers.”

He compared the fight for mid-level dental providers to what took place decades ago when physicians opposed nurse practitioners. Within the next 10 years, he predicts all 50 states will allow mid-level dental providers to practice.

The National Governors Association also has come on board. Currently. Alaska and Minnesota rely on mid-level dental providers, soon to be joined by Maine, while 15 other states are considering similar models to improve oral health.

The Pew Charitable Trust estimated that between 2010 and 2020 the annual spending for dental care by Medicaid would reach $21 billion because of untreated dental disease. In 2009, more than 830,000 emergency room visits across the country were attributed to preventable dental conditions. That same year, children visited the ER more than 49,000 times

Source: https://www.thelundreport.org/content/mid-level-dental-providers-gather-steam

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