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Why aren’t there dental therapists to provide lower-cost dental care?

Written by Diane Archer

Given that even simple dental care can be very expensive and that few of us have insurance to cover that care, why aren’t there dental therapists (the dental equivalent of a nurse practitioner or physician’s assistant)? We should not have to go to a dentist for simple dental services like fillings and simple extractions; a dental therapist, trained over two years to provide less complex procedures than dentists, could offer this care at lower cost.

Until recently, the American Dental Association had successfully blocked dental therapists from offering dental services in all states but Alaska, according to health advocate, Wendell Potter.  The dentists argued that the dental therapists did more harm than good.  Certainly, the dental therapists did harm to the pocketbooks of dentists, but there is no evidence of other harm.

New research suggests, in fact, that dental therapists can improve oral health and overall health outcomes.  And, they can do so at lower cost than dentists.  Alaska has permitted dental therapists to practice for more than 10 years with excellent results.  And, Canada, England, Australia and New Zealand have allowed dental therapists for several decades.

In the last several years, Minnesota and Maine have legalized the practice of dental therapy by dental therapists. And, it appears that over the next several years many more states may do so as well.  It’s important they do.  As Wendell Potter notes, 50 million Americans live in dental deserts, rural areas where there isn’t even a dentist to see if you could afford to see one.  

For more information about out-of-pocket costs for services Medicare does not cover, click here.

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  • Hear, hear! The dental trade organization, the ADA, has indeed lived up to its name. An organization of dentists designed to protect and advocate for dentists. There are many dentists who join who don’t believe in much of the ADA’s rhetoric and agenda, but belong for the benefits of insurance and so on. But make no mistake, the aDA lobbies hard to shape dental policy. Dental therapists are indeed working successfully for their clients in a few states. We should be able to move even further forward – away from the old “drill and fill” amputation techniques to less aggressive and conservative techniques like accurate, early diagnosis that can easily be accomplished by therapists applying technology like the Canary System or air abrasion/Diagnodent. With new dechnology, therapists scan diagnose and reverse problems extremely early, unlike the common current standard – picks and x-rays that are unreliable and best for late stage decay detection. This approach could extinguish the “built in obsolescence” of old techniques that break down teeth and lead to very expensive dental problems over a tooth’s lifetime. See more about advanced dental techniques you might be interested in, including biomimetic dentistry at http://www.mouthmattersbook.com, particularly the video “Avoiding the $6100.00 Death Spiral”. These techniques could start in dental deserts and poor countries, but move into major American cities once people realize they are missing out on some really advanced care!

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