Advanced dental hygiene practitioner

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nor take any referrals from the cleaning clinics of these midlevels if that nonsense bill goes through.

Uhhh, so let me get this straight. A patient comes in with a referral for RCT. You refuse to provide treatment to this patient (who, by the way, does not really give a **** about the politics of the provision of dental treatment) because his problem was tentatively diagnosed by a mid level dental practitioner?

Give me a break.

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No, I wouldn't necassarily refuse the patient themself, but I would just refuse the referral and treat the patient as just a new patient. I will be more than willing to explain to my new patients on why a totally new exam and xray would be required and why there is no point in getting a referral from some midlevel to see your dentist.
 
Well, I guess I could be wrong, but I don't really see how that is different from accepting the referral. I haven't met/shadowed any endodontists, but my guess is that they wouldn't perform a RCT on a referred patient without seeing xrays and examining the pt. themselves prior to the procedure.

Basically all you are saying is that you will take the referral but tell the pt. not to see the referring practitioner for their future dental needs.
 
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Right now in the eyes of the politicians who are agreeing with the ADHP's, the ADHP's are so charming. It seems they're the perfect solution for the dental access problems. They will not only do cleanings but also perform tasks of a dentist. However, they will provide these services at a much lower price, they will accept low governmental reimbursement rates, they will work in underserved areas. Dentist are so cruel, there is no such thing as a dentist who works in an underserved area. ADHP's are the solution, they will eat dirt and go to school for 2-4 years and dedicate their lives to being a quack dentist. Support the evolution of the quack dentist because they are the only socially conscious people who will treat hill billies.

I can't believe these politicians for being so ignorant. If you look at the ADHP's guidelines, they claim they won't be performing crown and bridge preps or RCTs. But that's all B.S. because after preping cavity preps, they will get bored and start pushing for crown preparations and then it only makes sense to start bridge preps and so on. And it is so funny how the ADHP's keep claiming that they will only do minimally invasive procedures, yet they want to perform extractions. What the f*ck is that? Last time I checked, any form of extraction is not minimally invasive unless that patient has a class 3 mobility and a furcation IV with bone lost of 80% or more. I can give a crap about these quacks as long as I don't ever have to come in contact with them. They better stay in those underserved areas that they talk soooOOOOoooOOO much about serving.
 
Advanced Hygienist Program to serve those in need and underserved areas??
Sounds more like a fast track DDS/DMD program to me. :rolleyes:


Since these super, CC grad hygienist think they could learn everything that a dentist has got to learn in 2 years...
How about if the Dental Assistant Association starts to push for a 1 year Advanced Dental Assistant Program so they could triple their income!
I bet these assitants can master their cleaning skills within a time of weeks wondering what the whole point of going through a 2 year DH program is..
I think I've heard that there is a shortage on dental hygienist in rural areas?
We need to get another bill passed for this crisis!


Well, if anyone has taken the time to research the ADHP concept, instead of regurgitating the misinformation and fear from their faculty and fellow students, they would realize that they've got it all wrong- First of all, how sensible would it be to take someone out of community college and have them play dentist? Doesn't sound so intelligent to me- Those pursuing a degree in advanced dental hygiene practice have to first complete an undergrad and then a 2.5 yr master's program- And as much as you would all love to believe that we would be enjoying supreme dental power, forget about it- An ADHP is required to have a collabortaive agreement with a DDS, and is limited on the services they can provide- And no, that does not make the signing DDS liable for any services rendered by the ADHP (no matter how completely unsafe they may be) Also, I've read several items regarding the safety of these "wanna-be" dentists- Really, I can promise you that after all of the education is completed for the ADHP, they graduate with much more clinical experience than the vast majority of graduating dentists- Even for something as simple as giving anesthetic, or placing SSC's, I, as an RDH, have performed it many more times than the graduating dentist- My point is, that in order to prove I am capable of and provide safety during the same procedures, I am asked to perform it many times more than you-Quite honestly, it sounds as though the pervasive attitude here is that only those who have applied for and been granted admission to dental school have the - capacity to apply knowledge and skill- Who do you think will be teaching the ADHP students? Dentists. Are these dentists not capable of imparting knowledge, or are we as hygienists just not capable of learning it? It's quite insulting, the whole superiority attitude. All of this nonsense being spouted here comes down to fear, misinformation, and money- Don't worry- You'll all still get paid, you'll all still have jobs- Nobody's taking anything away from you- Why don't I just go to dental school?- Simply, time- I'm in my 30's and have family and work commitments, and the ADHP model is the best way for me to make a difference at this point- I am fully understanding of the fact that I will not make nearly as much money as a DDS or have the scope of practice a DDS does-And strangely, that's okay-
 
Right now in the eyes of the politicians who are agreeing with the ADHP's, the ADHP's are so charming. It seems they're the perfect solution for the dental access problems. They will not only do cleanings but also perform tasks of a dentist. However, they will provide these services at a much lower price, they will accept low governmental reimbursement rates, they will work in underserved areas. Dentist are so cruel, there is no such thing as a dentist who works in an underserved area. ADHP's are the solution, they will eat dirt and go to school for 2-4 years and dedicate their lives to being a quack dentist. Support the evolution of the quack dentist because they are the only socially conscious people who will treat hill billies.

I can't believe these politicians for being so ignorant. If you look at the ADHP's guidelines, they claim they won't be performing crown and bridge preps or RCTs. But that's all B.S. because after preping cavity preps, they will get bored and start pushing for crown preparations and then it only makes sense to start bridge preps and so on. And it is so funny how the ADHP's keep claiming that they will only do minimally invasive procedures, yet they want to perform extractions. What the f*ck is that? Last time I checked, any form of extraction is not minimally invasive unless that patient has a class 3 mobility and a furcation IV with bone lost of 80% or more. I can give a crap about these quacks as long as I don't ever have to come in contact with them. They better stay in those underserved areas that they talk soooOOOOoooOOO much about serving.


Why are DDS/dental students so protective of their high speeds? Oh, and an ADHP can only perform "simple extractions". And we should be lucky to do that, considereing our limited intelligence and all-
 
Well, if anyone has taken the time to research the ADHP concept, instead of regurgitating the misinformation and fear from their faculty and fellow students, they would realize that they've got it all wrong- First of all, how sensible would it be to take someone out of community college and have them play dentist? Doesn't sound so intelligent to me- Those pursuing a degree in advanced dental hygiene practice have to first complete an undergrad and then a 2.5 yr master's program- And as much as you would all love to believe that we would be enjoying supreme dental power, forget about it- An ADHP is required to have a collabortaive agreement with a DDS, and is limited on the services they can provide- And no, that does not make the signing DDS liable for any services rendered by the ADHP (no matter how completely unsafe they may be) Also, I've read several items regarding the safety of these "wanna-be" dentists- Really, I can promise you that after all of the education is completed for the ADHP, they graduate with much more clinical experience than the vast majority of graduating dentists- Even for something as simple as giving anesthetic, or placing SSC's, I, as an RDH, have performed it many more times than the graduating dentist- My point is, that in order to prove I am capable of and provide safety during the same procedures, I am asked to perform it many times more than you-Quite honestly, it sounds as though the pervasive attitude here is that only those who have applied for and been granted admission to dental school have the - capacity to apply knowledge and skill- Who do you think will be teaching the ADHP students? Dentists. Are these dentists not capable of imparting knowledge, or are we as hygienists just not capable of learning it? It's quite insulting, the whole superiority attitude. All of this nonsense being spouted here comes down to fear, misinformation, and money- Don't worry- You'll all still get paid, you'll all still have jobs- Nobody's taking anything away from you- Why don't I just go to dental school?- Simply, time- I'm in my 30's and have family and work commitments, and the ADHP model is the best way for me to make a difference at this point- I am fully understanding of the fact that I will not make nearly as much money as a DDS or have the scope of practice a DDS does-And strangely, that's okay-

Wow! Somebody has a chip on her shoulder. Why does it make a difference that you are in your 30's. Many of my classmates were in their 30's and a few were in their 40's. You mention work commitments. If you have time to hold down a job during school - you are NOT getting equivalent training. Not possible.

This isn't about hygienists not being smart enough. I know construction workers smarter than some of my dental school classmates. It is about training. Either dentists are needlessly overtrained or the ADHP is undertrained. Take your pick, but there is no middle ground there.
 
Dental schools (in the US) are accredited by the Comission on Dental Accreditation. The Commission on Dental Accreditation is recognized by the U.S. Department of Education.

As far as I know, the ADHA is not recognized by the U.S. Department of Education.

Who accredits the schools that train the ADHP? The ADHA - a political group. Why is a political group accrediting schools? This is the reason community colleges can produce a faux-dentist.

The scope of practice for a dental hygienest in the State of Oklahoma (for example) is:

A. A dental hygienist may practice dental hygiene under the supervision of a dentist in a dental office or treatment facility. A dentist may employ not more than the equivalent of two full-time dental hygienists for each dentist actively practicing in the same dental office.

B. 1. A dentist may delegate to a dental hygienist the following procedures:

a. the duties and expanded duties authorized for dental assistants by the State Dental Act or the rules of the Board of Dentistry,

b. health history assessment pertaining to dental hygiene,

c. dental hygiene examination and the charting of intra-oral and extra-oral conditions, which include periodontal charting, dental charting and classifying occlusion,

d. dental hygiene assessment and treatment planning for procedures authorized by the supervisory dentist,

e. prophylaxis, which means the removal of any and all calcareous deposits, stains, accretions, or concretions from the supragingival and subgingival surfaces of human teeth, utilizing instrumentation by scaler or periodontal curette on the crown and root surfaces of human teeth, including rotary or power driven instruments. This paragraph shall not be construed to prohibit the use of a rubber cap or brush on the crowns of human teeth by a dental assistant who holds a current expanded duty permit for Coronal Polishing/Topical Fluoride issued by the Board,

f. periodontal scaling and root planing,

g. dental hygiene nutritional and dietary evaluation,

h. placement of subgingival prescription drugs for prevention and treatment of periodontal disease,

i. soft tissue curettage,

j. placement of temporary fillings,

k. removal of overhanging margins,

l. dental implant maintenance,

m. removal of periodontal packs,

n. polishing of amalgam restorations, and

o. other procedures authorized by the Board.

2. The procedures specified in subparagraphs b through o of paragraph 1 of this subsection may be performed only by a dentist or a dental hygienist.

3. Except as provided in subsections C and D of this section, the procedures specified in paragraph 1 of this subsection may be performed by a dental hygienist only on a patient of record and only under the supervision of a dentist. The level of supervision, whether direct, indirect or general, shall be at the discretion of the supervisory dentist. Authorization for general supervision shall be limited to a maximum of thirteen (13) months following an examination by the supervisory dentist of a patient of record.

C. 1. A dentist may authorize procedures to be performed by a dental hygienist, without complying with the provisions of paragraph 3 of subsection B of this section, if:

a. the dental hygienist has at least two (2) years experience in the practice of dental hygiene,

b. the authorization to perform the procedures is in writing and signed by the dentist, and

c. the procedures are performed during an initial visit to a person in a treatment facility.

2. The person upon whom the procedures are performed must be referred to the authorizing dentist after completion of the procedures performed pursuant to paragraph 1 of this subsection.

3. A dental hygienist shall not perform a second set of procedures on a person pursuant to this subsection until the person has been examined and accepted for dental care by the authorizing dentist.

4. The treatment facility in which any procedure is performed by a dental hygienist pursuant to this subsection shall note each such procedure in the medical records of the person upon whom the procedure was performed.

D. A treatment facility may employ dental hygienists whose services shall be limited to the examination of teeth and the teaching of dental hygiene or as otherwise authorized by the Board.


In DENTAL HYGIENE school, you learn to perform THIS scope of procedures. That is what a DENTAL HYGIENIST does.

If it is desired to perform more procedures than this scope of procedures indicates, it is required to attend an accredited dental school and become a DENTIST.

I really don't understand why the State of Minnesota doesn't understand that...

Would you want your wife? mother? friend? having a surgical procedure performed on them by a "Surgical Practitioner" with an education that was not accredited by the US Department of Education? I wouldn't.
 
Those pursuing a degree in advanced dental hygiene practice have to first complete an undergrad and then a 2.5 yr master's program- And as much as you would all love to believe that we would be enjoying supreme dental power, forget about it- An ADHP is required to have a collabortaive agreement with a DDS, and is limited on the services they can provide


Guys, quit freaking out! :boom: (<---- ooo that's really cool)
Did you all actually READ the bill that was linked in the very first post? These ADHPs are not your CC hygienists. You have to have a masters, just like the PA option in medicine. And you can't just go out and set up a practice "willy-nilly". You have to be collaborating with a dentist who dictates what procedures you can perform.

As a hygienist, I don't know of many of us who would actually go for this ADHP option. It doesn't really get you out from under the dentist. The only way to do that is to go to dental school. Dental hygienists often pick dental hygiene (rather than ADHP or DDS) because of the money, hours and lack of responsibility to run the practice. ADHP sounds like a pain in the butt to me.

I'm pretty sure California already does this ADHP thing.

I also think that foreign trained dentists aren't as alarmed by all this. In other countries, such as Armenia, their medical doctors have the equivalent education of a masters.
 
Guys, quit freaking out! :boom: (<---- ooo that's really cool)
Did you all actually READ the bill that was linked in the very first post? These ADHPs are not your CC hygienists. You have to have a masters, just like the PA option in medicine. And you can't just go out and set up a practice "willy-nilly". You have to be collaborating with a dentist who dictates what procedures you can perform.

As a hygienist, I don't know of many of us who would actually go for this ADHP option. It doesn't really get you out from under the dentist. The only way to do that is to go to dental school. Dental hygienists often pick dental hygiene (rather than ADHP or DDS) because of the money, hours and lack of responsibility to run the practice. ADHP sounds like a pain in the butt to me.

I'm pretty sure California already does this ADHP thing.

I also think that foreign trained dentists aren't as alarmed by all this. In other countries, such as Armenia, their medical doctors have the equivalent education of a masters.

Maybe you should do some research on NP's and CRNA's before posting. Both groups were supposed to be work under supervision of a physician, that is until they began to organize and lobby.

The first step with ADHP is to create them. Once there are enough of them, then they organize, contribute to a PAC, and lobby politicians for autonomy. Not everyone can get into dental school. The ones who can't become ADHP's and try to get the same privileges as dentists.
 
I like your sig, Taurus. So MD/DO patients never die because MD/DOs never make mistakes? (really it is a funny sig- I'm just being sarcastic)

But seriously, something needs to be done to address the issue of rising health costs and access to care.
We're all human, we all need access to affordable health care. It would be great if people in the US would quit being so greedy, over-worked and litigious and just get back to providing basic needs to each other. France is an excellent example. I'd love to move there someday... or Canada.
Utopia.
 
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It's not that we're scared it will hurt us financially. It will make less of a difference than increasing the dental school class size by the same amount. It's just that it's a really stupid idea that solves nothing and creates problems of it's own.

1. ADHP's are no more likely to practice in "underserved" areas than anybody else. This "underserved" argument is the ONLY real argument the hygienists have. It's not true and they know it, but it's all they have so they keep harping on that one.
2. It puts patients at risk by decreasing training - and this at a time when many dental educators are arguing for LONGER training and mandatory residencies. There is barely time to squeeze in the basics in 4 years of full time training. It CAN'T be done properly in 2 yrs of part time study.
3. There are very limited financial resources available for dental education. Why waste those resources producing "almost dentists" when that money could more efficiently be used to increase class sizes in existing schools and educate full scope dentists.
4. There are very limited numbers of dental educators out there. Almost every school in the country has MULTIPLE open positions. Why spread that resource out any thinner than it already is?

It's not that we don't think hygienists are smart enough. They are admitted to dental school all the time. I had 3 in my class and they are now fantastic dentists. We don't like this because it is a stupid political agenda that solves nothing and creates problems of its own.
 
I do think some dentists are afraid of the financial repercussions of ADHPs. I know as an RDH I would not like to move to Alabama right now b/c I'd be paid about half as much (they have preceptorship there for hygiene). So I understand that dynamic of the ADHP controversy.
Perhaps they should lower the educational requirements for dental educators and raise their salary so it's more attractive to teach than to go into private practice. We've got to have more educators anyway to teach the ADHPs or additional DDSs. The quality of care would ultimately go down, unless the ADHPs were restricted to areas that lack dental care.
The politics in any profession are disheartening. I'm not an ADHA member now. I used to be, but I found they didn't do anything for me when I needed them. The dues are ultimately just to pay for lobbying.
All this stuff really bums me out about dentistry (and medicine). If only we could all just practice and do what the patient needs without worrying about all the BS that goes with it.
 
I'm a dental student at the U of Minnesota and I had the oppertunity to sit with the dean of the dental school (Dr. Patrick Loyd). He said that he has sat at the table with many of the authers of this bill before it came out, and that they are ignorent. He said that all of them had very different intentions and at the end all of them wanted the bill to pass so they catagorized it as a "dental access bill." He also stated that dental access is not an issue specific to hygiene at all. It is an issue all in the dental field should be concerned with and not including dentists in the drafting and planning of the bill will only make hygenests isolated. My personal take (I went and discussed the matter with some state reps,) is that the bill was written in a very malicious manner. How dare them catagorize this bill as a dental access bill when the bill says nothing about where they would work? Had dentists and dentistry not apposed the bill by making noise, would they (the drafters) have been ok with the bill the way it was (W/O anything on liability, adhps could work under a dentist from anywhere in the US or world). And why where they against getting accredited by COPA (every dental school, hygiene, and dental assistant school in the US is accredited by COPA)? Where they that confident that they are incompitant?

the sad thing is that our school is getting devided. Hygenist, not all but I've seen it, are acting imature. I've seen them try to "grill" a dental student for signing a petition against the bill and calling him stupid. Most importantly, they (hygiene students) are getting misinformed by some hygiene faculty whom are by the way drafters of the bill.

I am sick of all of this... let them try it out.....in the mean time while the lawsuits hit the roof, we can make a new bill for dental assistants to do an advanced degree (6 months long) and they can do everything a hygenist can do.
 
It's not that we're scared it will hurt us financially. It will make less of a difference than increasing the dental school class size by the same amount. It's just that it's a really stupid idea that solves nothing and creates problems of it's own.

1. ADHP's are no more likely to practice in "underserved" areas than anybody else. This "underserved" argument is the ONLY real argument the hygienists have. It's not true and they know it, but it's all they have so they keep harping on that one.
2. It puts patients at risk by decreasing training - and this at a time when many dental educators are arguing for LONGER training and mandatory residencies. There is barely time to squeeze in the basics in 4 years of full time training. It CAN'T be done properly in 2 yrs of part time study.
3. There are very limited financial resources available for dental education. Why waste those resources producing "almost dentists" when that money could more efficiently be used to increase class sizes in existing schools and educate full scope dentists.
4. There are very limited numbers of dental educators out there. Almost every school in the country has MULTIPLE open positions. Why spread that resource out any thinner than it already is?

It's not that we don't think hygienists are smart enough. They are admitted to dental school all the time. I had 3 in my class and they are now fantastic dentists. We don't like this because it is a stupid political agenda that solves nothing and creates problems of its own.

Here's the thing... Why would I, as an ADHP, want to put my license, liability insurance, and credibility on the line by performing procedures that I am not properly trained, qualified, or comfortable doing? That doesn't make good sense. I fully agree that we cannot learn everything a dentist learns in 4 yrs, accelerated into 2 years. That's why we wouldn't be dentists, we would be Advanced Dental Hygiene Practitioners- This sets a very specific scope of practice. Anything beyond that is referred to the proper entity. And when you say things such as "almost dentist", it sounds attacking and condescending. I agree that there is no guarantee they will practice in underserved areas. But my guess is that, assuming all passes through legislation, most likely, they will only be reimbursed through MA, and other state type of insurances. And let's be real honest here, if the average insurance bearing person has the choice of seeking treatment through their DDS, or an ADHP, with no differnce in cost to them, they will most likely choose their DDS- The ADHP is an option for those people that the DDS doesn't want to see, basically. That's really what it all boils down to. Given, there are a lot of dentists that work in the public health sector, however, their patient load is generally filled to capacity, and many patients go unseen. What are they supposed to do? Continue waiting until their pain is so unbearable they go to ER and waste time, resources, and tax money there on something that could have been dealt with at a much ealier and more easily treated stage? THAT doesn't solve anything-
 
I'm a dental student at the U of Minnesota and I had the oppertunity to sit with the dean of the dental school (Dr. Patrick Loyd). He said that he has sat at the table with many of the authers of this bill before it came out, and that they are ignorent. He said that all of them had very different intentions and at the end all of them wanted the bill to pass so they catagorized it as a "dental access bill." He also stated that dental access is not an issue specific to hygiene at all. It is an issue all in the dental field should be concerned with and not including dentists in the drafting and planning of the bill will only make hygenests isolated. My personal take (I went and discussed the matter with some state reps,) is that the bill was written in a very malicious manner. How dare them catagorize this bill as a dental access bill when the bill says nothing about where they would work? Had dentists and dentistry not apposed the bill by making noise, would they (the drafters) have been ok with the bill the way it was (W/O anything on liability, adhps could work under a dentist from anywhere in the US or world). And why where they against getting accredited by COPA (every dental school, hygiene, and dental assistant school in the US is accredited by COPA)? Where they that confident that they are incompitant?

the sad thing is that our school is getting devided. Hygenist, not all but I've seen it, are acting imature. I've seen them try to "grill" a dental student for signing a petition against the bill and calling him stupid. Most importantly, they (hygiene students) are getting misinformed by some hygiene faculty whom are by the way drafters of the bill.

I am sick of all of this... let them try it out.....in the mean time while the lawsuits hit the roof, we can make a new bill for dental assistants to do an advanced degree (6 months long) and they can do everything a hygenist can do.

Wow- Please refrain from responding when you're uninformed- Unless and until you have actually READ the bill proposal, stop commenting- Assuming you have read previous posts, dental students are also capable of immaturity- So what is your answer? What's your solution? Do you agree with the MDA's counter? Or have you not educated yourself on that proposal either? How about stop asking others what your opinion should be and form your own?
 
I was wrong about the California thing earlier- it's the RDHAP option that they have now, which basically allows a hygienist with a bachelors and "x" hours of experience to have their own practice or provide service outside of an office setting. But they have to go to an underserved area to open a practice:
"...Dental health professional shortage areas, as certified by the Office of Statewide Health Planning and Development in accordance with existing office guidelines."
And it's only for dental hygiene services, not restorative.
Seems like that's a good way to do it- regulate the area where they can have a practice.
 
Wow- Please refrain from responding when you're uninformed- Unless and until you have actually READ the bill proposal, stop commenting- Assuming you have read previous posts, dental students are also capable of immaturity- So what is your answer? What's your solution? Do you agree with the MDA's counter? Or have you not educated yourself on that proposal either? How about stop asking others what your opinion should be and form your own?

I have read the bill. I also know some of the people who wrote it. Since last monday its had vital ammentments put on that the drafters purposely kept out. I dont believe there is a silver bullet for the problem of dental access, but there are many avenues such as load forgivement, better compensation for dental work. Do u think this adhp will be compensated as much as a dentist??

The only thing worse then ignoring dental access, is to pretend its bieng worked on an give our self a false sence of accomplishment. This bill was initially not designed to help the underprivledged, it was only catagorized as such. Please dont be dogmatic, if u disagree with points I raise, dont ask whether I've read the bill, u go read it. I've done more than read it. I've argued point by point with people involved here in the twin cities and all I hear is umms.
 
And let's be real honest here, if the average insurance bearing person has the choice of seeking treatment through their DDS, or an ADHP, with no differnce in cost to them, they will most likely choose their DDS- The ADHP is an option for those people that the DDS doesn't want to see, basically.-

Are you aware that there is already talk from some HMOs (metro dental, healthpartners) that they would require pts to go to ADHPs first and then via a referall to a DDS. Not be prejudice, a DDS doesnt mind seing "those people" as u call them. They are entitled to respect as any other patient. compensation isnt great with MA, but that is not the patients problem, that is the states informed decision to ignore dental access.
 
I have read the bill. I also know some of the people who wrote it. Since last monday its had vital ammentments put on that the drafters purposely kept out. I dont believe there is a silver bullet for the problem of dental access, but there are many avenues such as load forgivement, better compensation for dental work. Do u think this adhp will be compensated as much as a dentist??

The only thing worse then ignoring dental access, is to pretend its bieng worked on an give our self a false sence of accomplishment. This bill was initially not designed to help the underprivledged, it was only catagorized as such. Please dont be dogmatic, if u disagree with points I raise, dont ask whether I've read the bill, u go read it. I've done more than read it. I've argued point by point with people involved here in the twin cities and all I hear is umms.

I KNOW I won't be compensated as favorably as a dentist, don't worry! Also, I have read the bill, I am also from the Twin Cities and just waiting for the application for the ADHP program to become available- Do I think it's a silver bullet, nope- But loan forgiveness? Please.... So said recipient can set up shop for their required 3 years and then move on to greener pastures free of debt? Not to mention, there are very few of those programs available.Sounds like a winner in theory, but not so much. And please explain how better compensation for dental work will help? Do you mean charging more for dental work? That sounds counterproductive.
 
Are you aware that there is already talk from some HMOs (metro dental, healthpartners) that they would require pts to go to ADHPs first and then via a referall to a DDS. Not be prejudice, a DDS doesnt mind seing "those people" as u call them. They are entitled to respect as any other patient. compensation isnt great with MA, but that is not the patients problem, that is the states informed decision to ignore dental access.

I can't even imagine that being a possiblity, but let's just say for arguments sake that it were to happen... Let's say I, as an ADHP, would be seeing all incoming pts and essentially filtering them- Then what? Then the dentist only gets procedures designated as out of my scope of practice? The EXPENSIVE procedures? The RCT's, crowns, bridges, dentures, etc...? That would be tragic for the dentist to increase their revenue- Also, please don't try to take my statements out of context and patronize me- You know very well what I was saying by "those people"- If you would like me to address them from here on out as "the uninsured, underinsured, and underserved patients the dentists aren't willing to see", very well. I can play that game too!
 
I KNOW I won't be compensated as favorably as a dentist, don't worry! Also, I have read the bill, I am also from the Twin Cities and just waiting for the application for the ADHP program to become available- Do I think it's a silver bullet, nope- But loan forgiveness? Please.... So said recipient can set up shop for their required 3 years and then move on to greener pastures free of debt? Not to mention, there are very few of those programs available.Sounds like a winner in theory, but not so much. And please explain how better compensation for dental work will help? Do you mean charging more for dental work? That sounds counterproductive.

I am worried that ADHPs wont be compensated because, a bib and saliva ejector cost that same whether a dds used them or and rdh. Point I was making by that is just because adhps are getting paid less, so is the compensation, so whose saving the money, HMOs....
Loan forgiveness has worked and does it cost a lot. Sure it does. Every solution costs something, there is no free ride. What I meant by better compensation for dds and rdhs is that if MA covers more, I am more willing to go work in underprivledged areas where most ppl have only MA. That way, they get helped and dds and rdh can afford bieng there. I DID NOT MEAN CHARGING MORE FOR DENTAL WORK, U KNOW THAT. I believe that hygeine students need not get all defensive when dental students question this bill. adhps cant work without being under a dds license anyway. Dental student arent only concerned about it, so are many rdhs at our school. They are for the bill but they are also asking many question about why the bill was so deficient. If u read the bill u should also be thinking why it was missing so much. DDS and RDH can not function sepretly, that is a fact. They BOTH have dental access in thier mind as a concern, sometimes it is the means to achive solutions that are differed upon and that is healthy as long as INTENTIONS are maintained correctly.
 
I am worried that ADHPs wont be compensated because, a bib and saliva ejector cost that same whether a dds used them or and rdh. Point I was making by that is just because adhps are getting paid less, so is the compensation, so whose saving the money, HMOs....

Ideally, the ADHP won't mind making less of a profit. The ADHP needs to be happy with a less than $100K salary, whereas the DDS expects a $100-300+K salary. This is why so many dentists don't accept medicare/medicaid-they don't make a profit from these plans. (I don't blame them- they do have $400+K in loans to pay off.) So all the lower income people end up searching fruitlessly for a dentist who will take medicare, and when they find one, he is booked for a year. These are "those" people, who could see the ADHP instead.
What's better for the patient: no care or ADHP care?
 
The solution to ADHP's is don't hire them. Dentists who hire them are selling out the profession.
 
What's better for the patient: no care or ADHP care?

I think what many people see as the problem with this bill is that it does not provide any mechanism to ensure that these are the patients who will be treated by ADHP's. Why not add a provision that only allows them to treat medicaid patients?

The position has also been presented that even this would be unacceptable, as ADHP's working in medicaid clinics could be used as a stepping stone to their eventual presence in the wider dental community.

Personally I think it's fine if they are seeing medicaid patients. Double blind studies of restorations placed by dental therapists in Canada have shown them to be equal in quality to work performed by dentists (See pubmed ID #16006412)


Ideally, the ADHP won't mind making less of a profit.

I cannot disagree more with this. You're saying that they will be thinking to themselves "Well gee, since silly old me didn't go to dental school it's only common sense that I be compensated much more poorly for providing many of the same services as dentists." Umm no, people don't think this way.
 
I cannot disagree more with this. You're saying that they will be thinking to themselves "Well gee, since silly old me didn't go to dental school it's only common sense that I be compensated much more poorly for providing many of the same services as dentists." Umm no, people don't think this way.

Agreed. Never underestimate a group's greed. Did you know that CRNA's are the 10th largest healthcare-related PAC in Washington, DC even though they're just basically gas technicians? ADHP's will no doubt take a page from their playbook.
 
Ideally, the ADHP won't mind making less of a profit. The ADHP needs to be happy with a less than $100K salary, whereas the DDS expects a $100-300+K salary. This is why so many dentists don't accept medicare/medicaid-they don't make a profit from these plans. (I don't blame them- they do have $400+K in loans to pay off.) So all the lower income people end up searching fruitlessly for a dentist who will take medicare, and when they find one, he is booked for a year. These are "those" people, who could see the ADHP instead.
What's better for the patient: no care or ADHP care?

I totally understantd the feeling of trying to find a dentist who accepts state insurance. I had that experience myself. I do believe that a midlevel provider would be a great idea. It wouldnt solve the issue but it would for sure help. A lot of people are however very critical of this bill because they believe that is was prematurely sent and lacks addressing pressing issues such as liability, the curiculum, accreditation, dental access...
If we just think about the money, dentists might make tons off this whole thing. A dentist could open a clinic, hire 4 ADHPs (or midlevel providers), pay them a lot less than a dentist as u mentioned, but still charge close to what a dentist would charge and do all the expensive procedures themself. As for the no care of ADHP, I dont think that putting ourselfs in a corner and limiting our choices is the way to go. We need to be creative. Dentistry is an art. Mankind had found solutions to some of the most complex problems. We should not settle on something as the "do or die" solution. And when ppl question certain aspects of the bill or deficiencies they should not be met with anger and accusations. There is a common goal, stick to it TOGETHER. TOGETHER means, this is NOT a dental hygiene issue, this is a dentistry issue, that both RDHs and DDSs need to be involved it.
 
A dentist could open a clinic, hire 4 ADHPs (or midlevel providers), pay them a lot less than a dentist as u mentioned, but still charge close to what a dentist would charge and do all the expensive procedures themself.

This is all great until the ADHP's then lobby for autonomy. Dude, this has already been played out by the NP's and CRNA's. It's the same arguments, same pattern. Anesthesiologists made mad money supervising 4 CRNA's and billing for them. It was all great until the CRNA's lobbied for autonomy and got it.

If dentists fail to see ADHP's for the threat they are to their profession, then dentistry will follow in the footsteps of primary care and anesthesiology. Then, maybe you guys would have wished you went to medical school and became dermatologists instead. :)
 
So what happens to preventitive care when many RDHs are ADHPs or dental therapists. Are we going to have shortage of RDHs. I hope that HMOs wont push for an Advanced Dental Assistant Prac. That will just suck for everyone:eek:
 
Agreed. Never underestimate a group's greed. Did you know that CRNA's are the 10th largest healthcare-related PAC in Washington, DC even though they're just basically gas technicians? ADHP's will no doubt take a page from their playbook.

Wow! Seriously? Gas technicians? aren't we proud of ourselves- You haven't even graduated med school yet! Why is it that you want to discount every other profession with only slightly fewer years of education? I'm taking notes from their playbook as we speak- Which year is it that all of the arrogance begins? Or is it after you receive your acceptance letter?
 
So what happens to preventitive care when many RDHs are ADHPs or dental therapists. Are we going to have shortage of RDHs. I hope that HMOs wont push for an Advanced Dental Assistant Prac. That will just suck for everyone:eek:

That's like saying every dentist wants to specialize in perio or ortho- It's not gonna happen- Many hygienists only have an associates degree, and it's a much bigger commitment to go for those extra 4 years.
 
This is all great until the ADHP's then lobby for autonomy. Dude, this has already been played out by the NP's and CRNA's. It's the same arguments, same pattern. Anesthesiologists made mad money supervising 4 CRNA's and billing for them. It was all great until the CRNA's lobbied for autonomy and got it.

If dentists fail to see ADHP's for the threat they are to their profession, then dentistry will follow in the footsteps of primary care and anesthesiology. Then, maybe you guys would have wished you went to medical school and became dermatologists instead. :)

Dude... You're uncovering my secret plot to overthrow dentisty as we currently know it!
 
I think what many people see as the problem with this bill is that it does not provide any mechanism to ensure that these are the patients who will be treated by ADHP's. Why not add a provision that only allows them to treat medicaid patients?

That would be great! And limit the area of the state where they can practice to only areas with a shortage of dentists and hygienists.

I cannot disagree more with this. You're saying that they will be thinking to themselves "Well gee, since silly old me didn't go to dental school it's only common sense that I be compensated much more poorly for providing many of the same services as dentists." Umm no, people don't think this way.

I could just as easily say as a dentist performing molar endo, "well gee, since silly old me didn't go to endo school it's only common sense that I be compensated much more poorly for providing many of the same services as endodontists."
I am compensated less for SRP than the periodontist, and I see why- I don't have the additional training and expertise.
 
Ideally, the ADHP won't mind making less of a profit. The ADHP needs to be happy with a less than $100K salary, whereas the DDS expects a $100-300+K salary. This is why so many dentists don't accept medicare/medicaid-they don't make a profit from these plans. (I don't blame them- they do have $400+K in loans to pay off.) So all the lower income people end up searching fruitlessly for a dentist who will take medicare, and when they find one, he is booked for a year. These are "those" people, who could see the ADHP instead.
What's better for the patient: no care or ADHP care?

This is faulty thinking. You can find articles where dentists don't accept Medicaid not because the profit isn't big enough, but because it ends up being a negative profit. Even if the dentist donates his/her time, the overhead + materials to do 1 filling might cost $50 (as an example). Medicaid will reimburse $38 for that filling, and that is only after you jump through all of their hoops and fill out piles of paperwork to collect the $38. Why am I going to believe that the ADHP is going to go through all of this effort for a Medicaid patient when the overhead isn't going change to do that same filling? Is the ADHP going to accept $-12 profit from Medicaid? Highly unlikely.
 
Then, maybe you guys would have wished you went to medical school and became dermatologists instead. :)

naaa, I'd rather palpate an oral cavity not the anal cavity. :laugh:

Dude, I can go to my physician and he can tell me I need a CT scan, and I say, no doc, I'd rather want an MRI (a $hitload more expensive) and hell say, umm sure ( I HAVE SEEN THAT HAPPEN IN FRONT OF ME, I'VE WORKED IN HEALTHCARE). In dentistry patients have it worse. It wasnt too long ago that health insurances admitted to themselves that indeed, the mouth is connected to the body and it should be covered in someway under the insurance. Nowadays, if a patient wants a cavity fixed, the insurance tell them, to pay half of it. In case u dont know, it is considered surgery. They (Insurance compaines dare to argue with dentists and patients over less than $200, yet its a flip of the coin between an MRI and a CT. Dental access is indeed a concern that needs a group effort to solve it. As long as we can afford to say open and pay our loas, patients come first.
 
Umm, endodontists do get paid more per RCT by insurance companies than general dentists. But I'm not really sure what point you were trying to make with this.
 
I totally agree with Taurus. First it's all about solving the access problem, then it's going to be all about independence. I simply don't mind this bill as long as they specify where exactly these quacks can work. These quacks always talk about serving the poor and underserved, hey that's a brilliant idea to turn the politicians heads. How would you quacks feel if we start opening up 6 month teeth cleaning courses for dental assistants. Now what? In the end, this is not about serving the underserved but it's about serving the underworked and sometimes the brainless.
 
Why are DDS/dental students so protective of their high speeds? Oh, and an ADHP can only perform "simple extractions". And we should be lucky to do that, considereing our limited intelligence and all-

1. Because we know what they're capable of doing to a person in the hands of a provider with too little training, too much ego, and no ability to manage the problems they can cause.

2. Your mocking attitude toward "simple extractions" highlights, to me and every other properly trained dentist reading this, all the reasons you shouldn't be doing dentoalveolar surgery on patients. I can't even explain to you the reasons why your cavalier attitude toward oral surgery is so frightening, because you don't even know enough about it to appreciate their significance. A lot--most, even--extractions go as expected, but it only takes one unanticipated complication you aren't trained or equipped to manage to ruin your--and much more importantly, the patient's--whole day.
 
This is faulty thinking. You can find articles where dentists don't accept Medicaid not because the profit isn't big enough, but because it ends up being a negative profit. Even if the dentist donates his/her time, the overhead + materials to do 1 filling might cost $50 (as an example). Medicaid will reimburse $38 for that filling, and that is only after you jump through all of their hoops and fill out piles of paperwork to collect the $38. Why am I going to believe that the ADHP is going to go through all of this effort for a Medicaid patient when the overhead isn't going change to do that same filling? Is the ADHP going to accept $-12 profit from Medicaid? Highly unlikely.

Good point.
 
Umm, endodontists do get paid more per RCT by insurance companies than general dentists. But I'm not really sure what point you were trying to make with this.

Yes, that is the point I was trying to make- you just said it. Less education = less compensation. And that is what ADHPs can expect.
 
Yes, that is the point I was trying to make- you just said it. Less education = less compensation. And that is what ADHPs can expect.

Gotcha. I guess I didn't make my original point clearly enough. You seemed to be arguing that since ADHP's have less education, they would somehow be more willing to accept the lower paychecks associated with medicaid/public health work, or charge patients lower than the market rate for their services.
 
This is faulty thinking. You can find articles where dentists don't accept Medicaid not because the profit isn't big enough, but because it ends up being a negative profit. Even if the dentist donates his/her time, the overhead + materials to do 1 filling might cost $50 (as an example). Medicaid will reimburse $38 for that filling, and that is only after you jump through all of their hoops and fill out piles of paperwork to collect the $38. Why am I going to believe that the ADHP is going to go through all of this effort for a Medicaid patient when the overhead isn't going change to do that same filling? Is the ADHP going to accept $-12 profit from Medicaid? Highly unlikely.

Thanks- I wasn't aware of the exact numbers. That is crappy compensation (if you can call it that).
A negative profit is still a profit that isn't big enough. I don't think that qualifies as "faulty thinking".
Can we try to stay professional here?
OH WAIT. This is SDN. I forgot you guys have tempers and like to pick apart every post. Never a dull moment here!
 
Gotcha. I guess I didn't make my original point clearly enough. You seemed to be arguing that since ADHP's have less education, they would somehow be more willing to accept the lower paychecks associated with medicaid/public health work, or charge patients lower than the market rate for their services.

Well, yeah. That is what I'm saying. A dentist charges less than an endodontist for a root canal. A hygienist charges less than a periodontist for SRP. A ADHP would charge less than a dentist for a filling.
 
Thanks- I wasn't aware of the exact numbers. That is crappy compensation (if you can call it that).
A negative profit is still a profit that isn't big enough. I don't think that qualifies as "faulty thinking".
Can we try to stay professional here?
OH WAIT. This is SDN. I forgot you guys have tempers and like to pick apart every post. Never a dull moment here!

Stick to the point, so maybe using the word negative profit isnt ideal, how would u like to pay employees of yours to fillout paperwork so that you can then pay your patient with time and money to treat them? Do the math.
 
Man, I'm sick of this $hitt, I gotta study.
 
Stick to the point, so maybe using the word negative profit isnt ideal, how would u like to pay employees of yours to fillout paperwork so that you can then pay your patient with time and money to treat them? Do the math.

Well, maybe this ADHP thing will turn out to be the same as a dentist working in a volunteer clinic. You'd have to apply for grants to take medicare and see patients and depend on volunteer employees to assist you in seeing patients. Then the ADHP would just be living off of grant money. I know of a couple dentists who actually do that (work in a volunteer clinic for grant money pay).
 
Just because a dentist charges less than an endodontist for RCT does not mean he or she is accepting a price lower than the market rate for his services. The market values the expertise of an endodontist performing this procedure more highly than that of a general dentist.

Similarly, there will be a market price (which, you're right, will probably be a bit lower than it is for dentists) for restorations performed by ADHP's. If this price is above the level at which medicaid compensates for them, ADHP's will be no more likely than dentists to accept medicaid. Unless that is the only way they can practice.

Edit: Just to make my point a bit more clearly, ADHP's will also not be any more likely than dentists to work in a public health setting if they could make more money in private practice.
 
1. Because we know what they're capable of doing to a person in the hands of a provider with too little training, too much ego, and no ability to manage the problems they can cause.

2. Your mocking attitude toward "simple extractions" highlights, to me and every other properly trained dentist reading this, all the reasons you shouldn't be doing dentoalveolar surgery on patients. I can't even explain to you the reasons why your cavalier attitude toward oral surgery is so frightening, because you don't even know enough about it to appreciate their significance. A lot--most, even--extractions go as expected, but it only takes one unanticipated complication you aren't trained or equipped to manage to ruin your--and much more importantly, the patient's--whole day.

Whoa! Cool down there- my quotation marks were simply that- Quotation marks to denote a quote from the bill as one one of the delegated procedures- "simple extractions"- perhaps I should have cited it. I can assure you that my attitude is anything but cavalier, and as I've stated before, I have no interest in performing any type of procedure that I do not feel confident, properly trained, and comfortable doing. That would be silly and selfish and put my license, liability insurance, and credibility at risk! I'm glad you mentioned ego, because I keep forgetting to, and that is one major component of this entire situation. Who exactly do you presume will be education these ADHP's? I would certainly hope that a properly trained dentist might have the foresight to educate the students on all of the risks associated with simple extractions and the strategies for managing any problems occuring during said procedure-
 
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