Dental Therapy: A Tool for Economic Justice

  | By Izzy Litwack, Senior Policy Analyst, Community Catalyst
Dental Therapy: A Tool for Economic Justice

Although oral health is a critical part of overall health and well-being, its benefits extend into significant economic advantages for individuals and society at large. Oral health problems can cause debilitating pain, interfere with eating and sleeping, and affect one’s appearance and self-confidence leading to long-term economic consequences such as missed work, reduced job prospects and lower earnings. Oral health issues can also significantly impact children's ability to attend school regularly and perform well academically. 

 As with healthcare in general, low-income communities have substantially worse access to care than their higher income peers. However, this disparity is even worse in oral health. States are not required to provide comprehensive dental benefits to adults with Medicaid coverage and only half of states do so. And finding care can be a challenge even for people with Medicaid dental benefits as most dentists do not accept it. The high out-of-pocket costs of private dental insurance leave many people with it still unable to afford the care they need. Considering these barriers, it’s no surprise that 1/3 of Americans report having skipped dental care due to cost.  

Dental therapists, licensed oral health professionals who work under the supervision of a dentist to provide routine care like exams and fillings, can help break the cycle of poor oral health and poverty. By emphasizing preventive care and early intervention, dental therapists can help individuals avoid costly emergency or advanced dental treatments, which reduces the financial burden on individuals, insurance providers, and healthcare systems. By reducing the prevalence of dental issues and work or school absences, dental therapy contributes to better population health, an improved workforce, and educational engagement.   

In the National Partnership for Dental Therapy’s recent webinar, Dental Therapy: A Tool for Economic Justice, panelists discuss how dental therapy supports the goals and vision of economic justice. Watch the webinar at this link. Below is a look at some of the core principles that speakers asserted throughout their discussion.  

Webinar speakers included leaders based in Los Angeles, Seattle, and from national organizations:  

  • Gloria Medina, Executive Director, Strategic Concepts in Organizing and Policy Education (SCOPE)  
  • Marcy Bowers, Executive Director, Statewide Poverty Action Network  
  • Sarah Chagnon, Board President, American Dental Therapy Association & Dental Therapist  
  • Akil Reynolds, State Advocacy Manager, Community Catalyst, moderated the conversation
During the event, the panelists affirmed how oral health, dental therapy, and economic justice are tied together:   

Oral health represents a pivotal avenue for investment in communities, as reiterated by panelist Glorida Medina, the Executive Director of SCOPE. She shared stories of residents in South Los Angeles who actively engage in shaping policies that profoundly impact their quality of life. Through grassroots initiatives, community members have recognized various barriers to accessing oral health services, including issues related to affordability, physical accessibility, distrust towards dental providers, and the absence of viable career options within oral health for low-income communities of color. As we think about oral health, we must also consider comprehensive solutions through the lens of a caring economy, where rather than a system that extracts from its community, wealth and power are redistributed.    

When a dental clinic brings a dental therapist into the fold, both the clinics and the patients can see improvements in functionality and care. By embracing the expertise of dental therapists, clinics can operate at optimal capacity, leading to increased revenues and enabling every provider to practice to the full extent of their capabilities. Given that dental therapists receive specialized training that allows them to practice beyond traditional clinic settings, such as schools, senior centers, and mobile clinics, they serve as invaluable channels for extending the reach of quality oral healthcare cost-effectively, while simultaneously engaging in community outreach and education.  

Dental therapy is an innovative, strategic, and promising public policy solution that promotes economic opportunity and addresses systemic barriers to care. Historically, individuals grappling with poverty have faced steep obstacles in pursuing careers within the oral health sector. However, dental therapy was brought to the U.S. as a means of creating an accessible education pathway for individuals from underserved communities to become the providers their communities need. This creates good-paying jobs in these communities while improving the community’s oral health. Hiring dental therapists can be a cost-effective way for both nonprofit clinics and private practice dentists to grow their clinics, stimulating economic growth in local communities. 

 While other attempts to expand access to care, such as broadening adult Medicaid coverage, increasing reimbursement rates, and fostering collaborations with dentistry programs, have been pursued, they have failed to generate the transformative impact required to meet the needs of community members. Dental therapy, on the other hand, presents a scalable and genuinely transformative solution that has demonstrated its efficacy, particularly within Tribal communities that have led its implementation.  

 The panelists left participants with advice for organizations that may be considering dental therapy as a policy option for their communities. Marcy Bowers encouraged interested parties to ask themselves this question: What is the story you are trying to tell, and who are you asking to tell that story? The importance of narrative and allowing community members to share their own stories was woven throughout.    

 Dental therapy offers substantial economic benefits at both individual and societal levels. By expanding access to care, increasing clinics’ efficiency, improving school attendance and academic performance, and generating job opportunities, dental therapy positively impacts many economic factors. Recognizing the economic value of dental therapy is crucial for policymakers, healthcare professionals, and individuals, as it truly highlights the importance of investing in oral health and integrating dental therapy as an integral part of comprehensive healthcare systems.  

“At some point, there was no reason to not do dental therapy. There was no good reason to not pursue this as the right model because there is something for everyone to like about it.” - Marcy Bowers 

Photo credit: Children's Alliance (Seattle, WA)