Dental Care: Are Mid-Level Practitioners a Threat to Dentists?

Dental Care: Are Mid-Level Practitioners a Threat to Dentists?Can mid-level dentist practitioners give the same quality of dental care as a dentist?

This question is being raised in the Northwest where a Washington state dental practitioner bill passed through the Senate Health Committee.  The Senate version of this legislation moves out of committee and can potentially be considered by the full Senate.

If this bill passes in the Senate, Washington will be the next U.S. state to adopt a mid-level dental provider model to create both dental hygiene practitioners and dental practitioners, who will be supervised (offsite) by a dentist.

These practitioners will be allowed to provide various levels of dental care “pursuant to a written practice plan with a dentist.”

Dental hygiene practitioners would expand the scope of practice of the state’s hygienists, who can now place fillings after a dentist has done the prep work. They would receive specialized training to do extractions, handle medical emergencies, and administer some drugs.

Dental practitioners would be permitted to do everything that hygienists can do except scaling and cleanings. They could also do restorations, administer anesthesia, and extract primary teeth as well as loose permanent teeth (+3 to +4 mobility).

Both types of practitioners could work with offsite supervision if approved by their supervising dentist, but neither could do dental crowns, bridges, or complicated procedures. (Dr Bicuspid)

The Washington Academy of General Dentistry and the Washington State Dental Association oppose this bill siting, “insufficient training for diagnosis and a lack of direct supervision.”

What are your thoughts on mid-level dentist practitioners? Are they bad for dentistry?

For more: Washington Lawmakers Mull Dental Therapist Bills

Dental Hygienists Among the Fastest Growing Occupations in the U.S.

Occupational Outlook: Dental Hygienists Among the Fastest Growing Occupations in the U.S.According to the U.S. Bureau of Labor Statistics Occupational Outlook for 2008-2018, employment among dental assistants is expected to grow by 36 percent during the 10-year period, which is much faster than the average for all occupations.

Of the 20 fastest growing occupations in the US economy, half are related to healthcare.

Healthcare is experiencing rapid growth, due in large part to the aging of the baby-boom generation, which will require more medical care. As healthcare costs continue to rise, work is increasingly being delegated to lower paid workers in order to cut costs.

For example, tasks that were previously performed by dentists are now beginning to be performed by dental hygienists and dental assistants.

As dentists‘ workloads continue to increase from treating the aging boomer population, it is expected that the demand to hire more hygienists to perform preventive dental care will grow as dentists will want to spend more time working on more complex dental procedures.

There is also the growing situation of not enough dentists to provide adequate care in rural areas where hygienists are needed to fill in the gap. According to the Center for Rural Affairs, in 2007, approximately 15 percent of rural residents were 65 years of age or older, 25 percent greater than in the nation as a whole.

The U.S. population of those 65 or older is predicted to double by 2030, reaching 20 percent of the U.S. total population, and the fastest group age living in rural America are residents 85 and older.

The average median wage for dental hygienists is $32.81 hourly, $68,250 annually with the best employment opportunities following the population size of states. New York, Texas, California, Michigan and Florida employ the most dental hygienists.

See: Occupational Outlook Handbook, 2010-11 Edition — Dental Hygienists

Kansas University Pushes Degree Program for Registered Dental Practitioners

Kansas University Pushes Degree Program for Registered Dental PractitionersIn response to what Fort Hays State University sees as a shortage of dentists in Kansas, the Administration intends to create a bachelor’s degree program for registered dental practitioners if the Legislature authorizes this category of mid-level provider, according to The Topeka Capital-Journal.

The Journal reports that FHSU president Ed Hammond testified during a meeting of the Home-and-Community-Based Services Oversight Committee that the university would develop a baccalaureate degree program to train registered dental practitioners in Kansas.

These “registered dental practitioners” would be responsible for routine dental treatments such as teeth cleanings, fillings and preventive care.

Previous bills written to establish a dentistry career track, similar to nurse practitioners working with physicians, have not been passed by Kansas House or Senate committees.

The Journal further states that this time around the Kansas Health Foundation is funding the Kansas Dental Project, a campaign to convince Kansas lawmakers that registered dental practitioners would improve services to Kansas by working in conjunction with dentists and dental hygienists.

They claim that currently 93 counties in Kansas do not enough dentists to serve their residents.

Fort Hays State University is the fastest growing of the Kansas Board of Regents universities. It is located in Hays, Kansas, and is a state, tax-assisted institution.

For more on this story in The Topeka Capital-Journal see: FHSU endorses new dental career path

States Battle the Shortage of Dentists with Dental Health Aides and Hygienists

States Battle the Shortage of Dentists with Dental Health AidesThis week at the University of Minnesota the first class of dental therapists and advanced dental therapists will be taking their board exams.

Minnesota is one of the leading states in a new trend in dental care with the Minnesota legislature considering a a pending bill to allow dental hygienists to perform extractions and dental fillings without the presence of a dentist.

An alarming trend . . . ?

This seems to be just the beginning of what many dentists see as an alarming trend, as several other states are currently considering granting hygienists licenses to open their own hygiene practices without any supervision from a dentist.

These new types of dental health aides and dental health practices are suppose to improve access to dental care in places where dentists aren’t opening dental practices and with the (alleged) shortage of dentists to provide the growing care that is needed. Lawmakers argue that creating these new occupations will make it possible to treat more patients in areas currently being under-served.

Alaska already has the Alaska Dental Health Aide Therapist program, where high-school graduates receive 2 years of training in dentistry and are then licensed to practice most aspects of general dentistry, including extracting teeth.

But who will monitor the quality of their care if a dentist isn’t there to oversee the work?

A dentist has completed a minimum of two years of college and four years of dental school.  Specialists need a minimum of two more years of additional schooling. Dentists are trained to look for anything unusual like oral manifestations of diseases, oral cancer, infections — beyond just looking for the early signs of gum disease, dental decay and eroded fillings.

The health care reform law . . .

Adding to the need for more dentists is the recent passing of the health care reform law guaranteeing medical and dental coverage for nearly all children. This means an estimated 5.3 million more children will be obtaining dental coverage by the year 2014. States worry they will be hard pressed to ensure that the supply of dental providers will meet this growing demand for dental care.

Do you see this as an alarming trend?

For more on this subject see First Dental Therapists are Ready to be Put to the Test


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