Dental Therapists Could Bring Dental Care to Low-Income Residents

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Dental therapists are a new, master's degree level professional who mostly work in low-income areas. The only state that I am familiar with which has dental therapists is Minnesota. The Univerity of Minnesota School of Dentistry in Minneapolis offers the master's program in dental therapy and is the only U.S. dental school to award a degree in the field, according to the school's Web site. In some classes, dental therapy students, dental hygiene students, and dental students take some of the same classes and work side-by-side. In that state, there are two types of dental therapy licenses, Dental Therapist and Advanced Dental Therapist. The only difference is the degree of supervision by a dentist that is required. Dental therapists provide both preventative and restoration services and can do some of what dentists routinely do. They provide services to both children and adult patients. They can clean teeth, apply sealants, extract teeth, and fill cavities. They may be able to take impressions of teeth and perhaps even fit partials, but of that I am not sure. My state, like most states, does not allow dental therapists to become licensed and to practice. The state dental societies along with the American Dental Association are quite protective of the territory of dentists. This would be a practical way to bring dental care to low-income people. Needless to say, dental therapists cost less than do dentists, who, in my opinion, are overpaid. There still has to be a dentist present to supervise the dental therapist(s).

One additional point is that there are some kinds of oral surgery which I have discovered are not covered by dental surgery, because the procedures are considered to be medical, not dental. These are operations on the tissue inside of the mouth, not involving teeth, and other procedures, such as facial surgery. Most oral surgeons have the D.D.S. (or D.M.D.) degree, but a small number also graduated from medical school and have a medical degree. Even the surgeons who have both a dental and medical degree can only have medical insurance coverage that is out-of-network, and even then, even though they are trained physicians in addition to being dental graduates, you probably would have to get a letter from your personal physician saying that the procedure is medically necessary, and the oral surgeon would have to include it with the documentation of the procedure in billing medical insurance. Most oral surgeons are do not have a medical degree and therefore, only certain procedures, such as extracting an impacted wisdom tooth or putting in implants for replacement, artificial teeth would be covered, and like usual, there would usually be a co-payment or deductible. This is a field that most people don't pay any attention to unless they have a problem that needs the skill of an oral surgeon. In the old days, there were reports of the surgeon grabbing hold of an impacted tooth and yanking on it. Sometimes, a tooth will shatter, and they have to surgical remove the individual pieces. No doubt, it can be expensive.

Bernie Sanders had a bill at one time to add dental coverage to Medicare, but I am not sure how much such coverage would have cost. For those who are not eligible for Medicaid and who do not have dental insurance, which has co-payments and deductibles which can be expensive, lots of luck making payments to the dentist or oral surgeon.

Robindell's picture
Robindell
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Jul. 31, 2007 4:01 pm

Comments

good luck getting that one past the ADA backed state dental boards

dentists just like everyone else hates competition.

if it were up to me there would be no license to practice dentistry at all

Maine's picture
Maine
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Jul. 8, 2015 4:26 pm
Quote Maine:

if it were up to me there would be no license to practice dentistry at all

I could not help myself....I wondered to myself "What libertarian wisdom does Maine have to bestow upon us regarding Dentistry?"

I knew it would be good for a chuckle and it was.

Here's your libertarian Dentist, Maine. ROFL...

al3's picture
al3
Joined:
Jul. 31, 2007 4:01 pm
Quote al3:
Quote Maine:

if it were up to me there would be no license to practice dentistry at all

I could not help myself....I wondered to myself "What libertarian wisdom does Maine have to bestow upon us regarding Dentistry?"

I knew it would be good for a chuckle and it was.

Here's your libertarian Dentist, Maine. ROFL...

if there's somebody out there who is willing to pay for the three stooges to do their dentistry, I will not stand in their way.

In reality, the "real" dentists will continue to exist without licenses, only now they will also have to compete with people like the ones who hold the OP's masters degree and others who perhaps only hold a bachelor's degree. The people will decide which kind they prefer and they will vote with their wallets.

And if you want to apply socialized health care plans to it, then sure the socialized health care plans can still specify that they will only cover doctors that meet certain requirements.

Maine's picture
Maine
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Jul. 8, 2015 4:26 pm

Who knows more about and is more academically qualified to understand dental therapists, their training, and their scope of practice, some right-wing fringe individual on some Web site, or the University of Minnesota School of Dentistry? I have had fillings where the dentist drilled on the side of the tooth to rough up the surface, and then a technician came in and applied the white goop that is put on the side of the tooth. Dental therapists only do certain procedures for which they are not only trained, but supervised by law by a dentist. This was omitted by the extremist, which is what conservatives tend to do. It is about lowering the cost of certain but not all needed dental services. Conservatives criticized the Affordable Health Care Act for not doing enough to lower health care costs, although their criticisms are not knowledge-based as they can't imagine someone not having $100,000 or even $10,000 for some kind of procedure or medication.

Nurse practioners often work in doctor's offices and see patients when the doctor is too busy or when a patient has a condition that doesn't seem to be that serious and might be treated just as well by a NP than by a physician. The NPs can prescribe certain drugs and can screen out patients who don't need to see a doctor for their complaint. Usually, insurance covers anyone in the office, both doctors and Nurse Practioners. Optometrists often have advanced equipment and may sometimes do a more throrough than even an opthamologist might. If something is amiss, they would probably refer the patient to an M.D. A lot of opthamologists have optometrists who work in the same office. Optometrists might even do a more accurate job in some cases than an opthamologist in writing a prescription for lenses, although I can't say that for sure.

News flash: Alaska, a mostly rural, wilderness state which has a significant native population, also uses dental therapists to reach areas where people need basic treatment but may not have very good or any dental insurance. A number of dentists have commented that most commercial dental insurance plans are woefully out-of-date and inadequate in the amounts they allow for coverage of different procedures.

Robindell's picture
Robindell
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Jul. 31, 2007 4:01 pm