Dentists Think Mid-level Oral Health Providers Are a Bad Idea

Dentists Think Mid-level Oral Health Providers Are a Bad IdeaA recent The Wealthy Dentist survey of dentists showed 53% believe that alternative dental providers are a bad idea.

Dental Health Aide Therapists already provide care in Alaska Native territories and in Minnesota, while Kansas, Connecticut, Maine, and New Hampshire legislatures, along with several public health communities around the U.S., are considering the mid-level dental provider model.

59% of the dentists who responded to this survey believe that there should be fewer alternative providers than there already are.

In this survey, dentists also question whether mid-level oral health providers can sustain the same standard of care as a licensed dentist.

As one California dentist put it, “I went to college and dental school for eight years in order to receive the education necessary to safely perform irreversable procedures upon the human body. It is clear that this level of education cannot be achieved in two or three years. Isn’t it interesting that the proponents of the low-level provider scheme intend that it be used for OTHER people’s healthcare, and not for their own?”

Here’s how the dentists answered the question: “What are your thoughts on alternative dental providers?”

  • 22% — Good! Alternative providers increase access to dental care.
  • 53% — Bad! I am concerned about the level of care they can provide.
  • 25% — Not sure. I don’t know how the benefits weigh against the risks.

The vast majority of dentists, who think alternative providers are a bad idea are suburban dentists. Rural dentists are most in favor of mid-level providers, while urban dentists are most unsure about this type of dental care.

Here’s what dentists had to say about alternative dental providers —

“They won’t be going to the shortage areas, which is where the need is because there will not be the money they want or need to practice successfully. A better alternative is to pay student loans in exchange for dentists going to the shortage areas. We are just like politicians, people go for the money. Why establish a whole new curriculum and physical schools that will cost a lot more than paying student loans?” (Missouri dentist)

“If you want to provide dental care . . . GO TO DENTAL SCHOOL!” (General dentist)

“I don’t see a safety issue. I see a need for a public health system to employ them… otherwise, insurance companies and entrepenurial dentists will employ them and use them to crush our ability to make a living in private practices.” (Illinois dentist)

“I dislike the term ‘alternative dental providers’, it makes it sound like plumbers or shoe repair people could potentially do dentistry.” (Maryland dentist)

“We have no access-to-care problem here, we have a lack-of-patients problem.” (Rhode Island dentist)

“I know dentists are able to see more patients without a decrease in quality. They just need an incentive to reach out to underserved areas.” (Oregon dentist)

“I have had an RDAEF2 for nearly one year now and I think this is a real win-win-win for dentistry, for auxiliaries and for dental patients. My RDAEF2 is caring, competent, talented and all-around wonderful. She has increased my production without increasing my stress level. When I turn a procedure over into her competent hands, I describe her to my patients as being comparable to a nurse practitioner or physician’s assistant but in the dental sphere. Patients have been very accepting of her and I know they are well cared for by her. She has been, for me and in my practice, better than an associate. With associates, I was constantly baby-sitting them to make sure they weren’t missing diagnoses, saying the wrong thing, or treating a situation inadequately or, God forbid, ineptly. With my EF2, I diagnose, numb, prep and turn it over to her with a final check by me. My production has shot up while the standard of care remains the same or better. (California dentist)

“This access to care debate is mostly a myth to make the politicians look good!” (South Carolina dentist)

“This is the only way we will be able to meet present and future under-served.” (Connecticut endontist)

“Bad idea. There is a reason why dentists go to dental school in order to be properly trained to provide competent care to patients.” (Alabama dentist)

“In the Indian Health Service clinic dentists anesthetized and prepared teeth, trained assistants filled and adjusted, dentists checked and signed off. It allowed us to see twice as many patients in a day and they did beautiful work. This model could work in public dentistry clinics and increase access at a lower price and risk.” (Texas dentist)

“There’s no real need. If patients and insurance valued dental care with proper payment for services, they could use the existing infrastructure of dental availability.” (Nevada dentist)

What are your thoughts on the idea of mid-level oral heath providers? Do you think that it is a good idea?

Let us know your thoughts in the comments.

Holistic Dentistry: Methods for the “Alternative Dentist”

Holistic dentist: alternative dentistryDentists: why should you care about “Alternative” dental approaches? Because large segments of your dental market care. In these tough economic times, it pays to know enough about these alternatives to be able to discuss them intelligently when patients ask questions about them. From a dental marketing point of view, it is imperative that you treat these questions with respect.

Do you know exactly what holistic dentistry is? How about “biological dentistry”? What about things like dental homeopathic medicine, Dental Somatic Integration™, and mercury chelation therapy?

Well, this week I’ll walk you through some of what “alternative dentistry” has to offer…

Dr. Weston Price, DDS (1870-1948) is the dentist often considered the father of the holistic dental movement. In comparing “modern” cultures with traditional, tribal peoples, he concluded that our modern diet leads to all manner of health and dental problems: caries, impacted wisdom teeth, allergies, fatigue, and even cancer. [Learn more about Dr. Weston Price]

Dr. Price also campaigned passionately against root canals, arguing that they leaked bacteria and other toxic materials into the body. To this day, many a holistic dentist opposes root canal therapy.

Holistic dentistry (sometimes called “wholistic dentistry“) – like all types of holistic medicine – dictates that the patient be treated as a whole person. This view of the holistic dentist is somewhat at odds with today’s widespread concept of dentists as oral health practitioners who have little to do with the rest of the body.

Nutrition and body chemistry are key concerns of holistic dentistry. Holistic dentists may use blood tests or hair samples to monitor patients’ nutrient levels, offering nutritional supplements or dietary counseling.

Holistic medicine strives to meet the psychological, emotional and spiritual needs of its patients, helping to tap self-healing potential. It also views the whole person as deeply connected to the person’s physical and emotional environment. [Learn more about holism]

Some holistic dentists also use homeopathic medicine, which is a particular form of alternative medicine. Based on the concept of “like cures like,” homeopathic medicines are successive dilutions of a natural substance that causes symptoms similar to those the practitioner is trying to cure. [Learn more about homeopathic medicine]

Though most often practiced by chiropractors, applied kinesiology issometimes used by holistic dentists. Dental Somatic Integration™ is based on the idea that fixing tooth problems can heal pain or injury in other parts of the body. [Learn more about Dental Somatic Integration™]

TMJ patients may be offered cranial therapy (also known as “cranial osteopathy” or “craniosacral therapy“) to relieve TMJ pain. This therapy involves manipulating the bones of the skull and jaw as well as the “rhythm” of the cerebrospinal fluid.

Biological dentistry focuses on using bio-compatible dental materials, acknowledging that different patients may have different biocompatibility. The biological dentist is particularly concerned with mercury and other metals used in dental restorations, both in terms of toxicity and “oral galvanism” (electrical currents generated by these metals). Biological dentists also argue that many patients have areas of decay and dead tissue, known as dental interference fields or foci. [Learn more about Biological dentistry]

Mercury-free dentistry (not quite the same thing as mercury-safe dentistry) has perhaps gained the most widespread acceptance. A number of dentists (according to our survey on mercury amalgam fillings, up to half of dentists) feel that mercury amalgam may not be a safe treatment. Most commonly, these dentists offer composite fillings instead. Some actually recommend patients have existing silver fillings removed. A few even offer chelation therapy as a way of removing toxic mercury from the body.

Want to learn more? Here are some links you may find interesting:

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