About Dental Therapy

The Problem

Where you live and how much money you make shouldn’t determine your access to dental care but that is exactly the case for many Americans. Almost 60 million Americans live in areas without enough dental providers and almost one-third of adults report having skipped dental care due to cost. And finding dental care can be a particular challenge for families with Medicaid coverage as only around one-quarter of dentists accept it. Put all together, these barriers have created serious inequities in access to oral health care and in oral health status for low-income families, Tribal communities and community of color, rural areas, kids, seniors, and people with disabilities.

Alaska Dental Therapist Aurora Johnson shows a group of kids how to properly brush their teeth. (Photo credit: W. K. Kellogg Foundation)

How Dental Therapists Can Help

Dental therapists are licensed providers that work under the supervision of a dentist to provide routine dental care like exams and fillings. They are a flexible addition to a dentist-led team, complementing the work of dental hygienists and dental assistants and freeing dentists up to focus on more complicated care. 

Dental therapists work in a variety of settings, but they are specifically trained to extend routine care into chronic shortage areas. Working under the off-site supervision of a dentist and collaborating via telehealth, dental therapists can bring care to people where they are, whether that’s schools, nursing homes or rural communities. Because their employment cost is one-third to one-half the amount of a dentist, hiring dental therapists has proven to be a cost-effective way for a range of dental care settings to treat more low-income and uninsured patients with the same budget. 

Dental therapists are currently authorized in some or all settings in Alaska, Arizona, Connecticut, Idaho, Michigan, Minnesota, Maine, New Mexico, Nevada, Vermont, and Washington, as well as through pilot programs in Oregon. Over a dozen other states and Tribal governments are in the process of exploring authorization of dental therapists.

The Origins of Dental Therapy

Dental therapists have worked around the world for a century. The first U.S. dental therapy program was initiated by Alaska Native/American Indian leaders to address chronic dentist shortages in their communities. The ability of dental therapists to travel to remote areas quickly made an impact. They are now expanding their work to a wide range of dental shortage areas and traditional office settings in other states. 

In Minnesota, similar oral health care gaps for vulnerable populations led a coalition of consumers, educators and oral health leaders to launch a campaign to authorize dental therapists in 2007. The Minnesota legislature authorized dental therapists in 2009. The first classes graduated in 2011. 

In 2015, the Commission on Dental Accreditation, the same body that approves education programs for dentists, established national accreditation standards for dental therapists. Currently, three schools are graduating providers, two in Minnesota and one in Alaska and a number of new programs are in development.

Building a More Representative Workforce

Many rural and low-income communities struggle to recruit and retain dentists and the dental providers in those communities often do not share the language or culture of the community they treat. Dental therapy focuses instead on building a dental workforce from communities. Because dental therapists do a narrow set of commonly needed procedures, they can be trained in far less time and at far less cost than a dentist. This allows local colleges to build an accessible workforce pipeline, creating both good paying jobs and better oral health.

FREQUENTLY ASKED QUESTIONS

What is a dental therapist?

Dental therapists are licensed dental care providers that provide community education and some of the most common dental procedures such as preparing and filling cavities. They work as part of a dentist-led team complementing the work of dental hygienists and dental assistants.

How do dental therapists improve care?

Dental therapists can work in any setting, but they are specifically trained to extend routine care into chronic shortage areas. They provide community education and the most frequently needed procedures including preparing and filling routine cavities and simple extractions. Dental therapists work as a part of the dentist-led dental care team including dental hygienists and dental assistants. They help to increase the capacity and productivity of the full team.

Where are dental therapists educated?

The Commission on Dental Accreditation, the same body that approves education programs for dentists, passed national accreditation standards for dental therapists in 2015. Currently, three schools in the U.S. are graduating providers, two in Minnesota and one in Alaska. Several more colleges and universities, including schools in Minnesota, Vermont and Washington are preparing to educate dental therapists.

Are dental therapists and dental hygienists the same?

No. Broadly speaking, dental hygienists are experts on the soft-tissue (gums) and prevention while dental therapists primarily focus on the hard surfaces (the teeth) and filling cavities. Some schools offer dual-track education programs or give advanced standing for hygienists who wish to pursue dental therapy. 

Where are dental therapists authorized to practice?

Dental therapists are authorized in some or all settings in Alaska, Arizona, Connecticut, Idaho, Michigan, Minnesota, Maine, New Mexico, Nevada, Vermont, and Washington, as well as through pilot programs in Oregon. Over a dozen other states and Tribal governments are in the process of exploring authorization of dental therapists.

Please help bring visibility to this issue by having your organization endorse dental therapy.