KHI News Service

Worldwide review says mid-level dental providers give good care

By | April 10, 2012

More than 50 million Americans lack access to dental care, but only two states – Minnesota and Alaska — allow mid-level dental providers to practice basic dental services on low-income, low-access communities.

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KPR story: Mid-level dental providers give good care, report finds

Today a report released by the W.K. Kellogg Foundation looks at 26 nations and territories’ experiences with mid-level dental therapists, and found that they provide good quality, cost-effective care and, in many countries, provide improved access to care for children.

The study spans 1,100 documents from 26 of the 54 countries and territories that use the mid-level dental providers. Some countries, such as New Zealand, have the dental therapists concentrate on children’s dental health, often working through the public school systems. The result: “over 60 percent of children ages 2 to 4 years were enrolled in and utilized the publicly funded child oral health services” and the average cost of school-based dental services was $99 (U.S.) per child.


Report on Dental Therapists

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Dental Therapists, summary

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While some states — including Kansas — are considering legislation to start training the next batch of dental therapists, the proposals face opposition from professional dental groups.

Dr. David Nash, the lead author of the 460-page review and a professor of pediatric dentistry at the University of Kentucky, says the study highlights the positive effects of implementing dental therapists.

“It probably needs to be said pretty bluntly today that our system of providing oral health care, particularly for children in this country, is ineffective, inefficient and it’s extremely expensive and it really deprives children of decent care.”

Nash says while the 2010 health law expands Medicaid dental benefits to include 5.3 million children, many dentists do not accept the public insurance program. Furthermore, Nash says children’s dental services are not as profitable for private dentists.

“There are more dentists that are scared of children than there are children afraid of dentists” Nash says. “It was said 50 years ago, and it’s still true today that caring for children in a dental practice is not particularly financially advantageous.”

According to the review, opponents of dental therapists say that funding better Medicaid reimbursements for dentists will help create better access and better quality care for children on Medicaid. In February, the American Dental Association released a statement in response to a Pew report on patients seeking dental care in hospital emergency departments calling the use of mid-level providers “wrongheaded.”

However, the Kellogg Foundation study found support within the dental profession for the role of dental therapists in countries that have them, and that “once dental therapists have been introduced in a country, professional support for them increases over time.”

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Related coverage: Kansas' Oral Health Care Provider Shortage

Bill considered that would allow dentists to have more practice locations (2/18/14)
Statehouse push made for mid-level dental practitioners (2/12/14)
Americans for Prosperity joins effort to license mid-level dental providers (1/8/14)
Kansas Medicaid program still lags nation in oral health care for kids (11/12/13)
Kansas dental program for children on hold because of KanCare MCO (11/11/13)
Dental mediation effort ends without compromise (11/4/13)
Disputing parties enter formal mediation over mid-level dental providers (10/3/13)
Pew report cites need for mid-level dental providers (6/25/13)
Dentist groups announce scholarships for dentists going to rural areas (2/7/13)
Advocates for mid-level dental providers meet with legislators (2/6/13)
Bill to license mid-level dental providers introduced (1/29/13)
Regents will hear proposal to train mid-level dental practitioners (10/17/12)
Dentist shortage proposal not funded in Regents' recommended budget (9/20/12)
Report questions economic viability of mid-level dental providers (7/26/12)
Task force recommends building state's first dental school (6/21/12)
Dentists shouldn't fear mid-level dental care, expert says (4/20/12)
No consensus on how to end ‘dental deserts’ (4/9/12)
Worldwide review says mid-level dental providers give good care (4/10/12)
Bill to increase dental care access given initial approval in Senate (3/15/12)
New caucus told of oral health success in southeast Kansas (3/8/12)
More Kansans head to ER for dental care (2/29/12)
Dental association says new program will increase access in rural areas (2/2/12)
‘Turf battle’ continues over dental practitioner bill (1/30/12)
Summit to focus on training plan for mid-level dental practitioners (11/29/11)
Between a hygienist and a dentist, a hard sell (10/26/11)
Political fight continues over mid-level dental practitioners (10/11/11)
Better prevention would help solve dentist shortage, advocate says (7/22/11)
Dentists: Practitioner bill flawed (3/9/11)
Videos detail shortage of Kansas dental providers (12/8/10)
Slow going in efforts to solve state’s dentist shortage (8/30/10)
Safety-net clinics filling gap in dental services to low-income Kansans (8/30/10)
Replacing town’s only dentist ‘hardest’ project ever (8/30/10)
Progress made on oral health, but problems remain (1/14/09)
Funding bill contains seed money for 'dental hubs' (5/4/07)
Increasing access aim of oral health coalition (12/21/06)

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