Dental therapist

[Titus Times]

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Ok we have all been hearing talk of these dental therapist, and how they will be able to perform procedures such as Root Canals, fillings, extract primary teeth, take X-rays and remove nerves in primary teeth.

Some people seem to be worried about this but My question is, Whose going to train these "Dental Therapist". If we have only dentist currently doing these things now then it would take a dentist to pass the skills on.

If current dentist simply dont train these midlevels then dental therapy will not expand any further no?

Discuss

 

[NDPitch]

Dental Therapist programs at schools... These don't exist yet (in volume). Programs will likely start popping up in the future once DTs are cleared to enter the workforce. That's pretty much it. Then, supposedly, dentists would have to hire them to be in their practice. This is one of the arguments against DTs that you hear around here - that DTs would flood out associate positions because they're cheaper.

 

[little Buddy]

I think hygienists will have more to fear. Why not hire these over a hygienist?

 

[Titus Times]

I agree with you both, and we all know a DT cant open up a practice so how will they reach an Underserved area before a Dentist does if they need a Dentist office there to even rob the dentist of his job.

To me it has "poorly thought out" written all over it

 

[NDPitch]

I agree with you both, and we all know a DT cant open up a practice so how will they reach an Underserved area before a Dentist does if they need a Dentist office there to even rob the dentist of his job.

To me it has "poorly thought out" written all over it

This is pretty much what happened with PAs and NPs in medicine. A very small amount worked in under served areas. The majority went to the desirable places to work. I agree. Poorly thought out. The dentist/hygienist model works well. We just need to get them into under served areas. No need to create a new position for it. I think some kind of incentive could be created to get the dentist/hygienist combo into underserved areas.

 

[Titus Times]

This is pretty much what happened with PAs and NPs in medicine. A very small amount worked in under served areas. The majority went to the desirable places to work. I agree. Poorly thought out. The dentist/hygienist model works well. We just need to get them into under served areas. No need to create a new position for it. I think some kind of incentive could be created to get the dentist/hygienist combo into underserved areas.

I agree, as we see with PA's an NP's these careers attract people not for reasons of serving the underserved majority of people that I know who want to be PA's don't realize that it originated to thwart the Primary care shortage in underserved areas.

Hopefully instead of putting money into these DT programs we can put money into incentives for dentist in rural areas. I find it so ironic that there are threads about saturation and is dentistry a viable career these days yet DT is created to combat a shortage of dentist.

 

[jwdent]

Interesting points brought up here. I cannot see dental therapists going out on their own. Economically it would be very tough to do so. A therapist would need very similar facilities of a dental office. I think it would be difficult for the therapist to even just cover overhead on reduced fees of the less expensive procedures a dentist does (ie fillings and extractions). This two tiered system would probably have to be supported by state governments. Which if this was the case, I think the money would best be spent forgetting about therapists, and rather placing incentives for dentists to practice in undeserved areas; Maybe by setting up residency type programs or loan repayment programs for a few years of service. I'm sure many new grads heavily indebted new grads would jump at the opportunity to practice a few years in an undeserved area if some sort of loan repayment was being offered. The new grads would be able decrease a good portion of their debt for a few years of service and then move on if they choose. Plus the high standard of care would not be reduced to a tier system.

 

[HeadgearBraces]

The dentist/hygienist model works well. I think some kind of incentive could be created to get the dentist/hygienist combo into underserved areas.

👍

 

[pantzed]

Thinking about the growth of dental therapists scares me as a current applicant to dental school. Not only does it threaten many jobs of dental professionals, but I believe that letting dental therapists perform surgeries is completely unethical. I agree that access to care is a problem, but giving patients who live in underserved areas lower quality care for cheaper (not even necessarily cheaper) is not right. Irreversible surgical procedures by undertrained therapists is wrong.

Is there anyway we can fight this? Any laws or bills that we can try to veto?

 

[Titus Times]

Thinking about the growth of dental therapists scares me as a current applicant to dental school. Not only does it threaten many jobs of dental professionals, but I believe that letting dental therapists perform surgeries is completely unethical. I agree that access to care is a problem, but giving patients who live in underserved areas lower quality care for cheaper (not even necessarily cheaper) is not right. Irreversible surgical procedures by undertrained therapists is wrong.

Is there anyway we can fight this? Any laws or bills that we can try to veto?

I personally feel like our general consesus as pre dents is a sign of hope. Consider this if we all agree (granted only a few of us have posted) that this is wrong any way you turn it, then the rest of Dentist likely share the same feeling.

And like I stated someone has to train these therapist to do these procedures and as of now only Dentist do them so Its likely in the Dentist control whether this goes through or not.

 

[pantzed]

I personally feel like our general consesus as pre dents is a sign of hope. Consider this if we all agree (granted only a few of us have posted) that this is wrong any way you turn it, then the rest of Dentist likely share the same feeling.

And like I stated someone has to train these therapist to do these procedures and as of now only Dentist do them so Its likely in the Dentist control whether this goes through or not.

I don't get your point. Dental therapists have already existed and have already gone through training. This is not some new age career, even though it's fairly new. Dentists dont train or control therapists, technical schools do.

 

[healthysmile]

I don't get your point. Dental therapists have already existed and have already gone through training. This is not some new age career, even though it's fairly new. Dentists dont train or control therapists, technical schools do.

In the U.S. Dentists DO train dental therapists. In Alaska the program was started and led by a dentist who graduated from the Ohio State University College of Dentistry and now lives in Alaska. In Minnesota, "Dental therapy students take several courses with dental and dental hygiene students, and all students learn together in School of Dentistry clinics, which model a general practice" (i.e. not a "technical school.")

http://www.dentistry.umn.edu/programs-admissions/dental-therapy/bachelor-program/index.htm

And you are right that the career is fairly new in the U.S. but it has been around for decades in other countries. I personally think that whether or not states allow DTs to become trained and licensed will ultimately depend on the weight/influence of each state's dental association in their respective State Houses.

 

[jwdent]

I personally feel like our general consesus as pre dents is a sign of hope. Consider this if we all agree (granted only a few of us have posted) that this is wrong any way you turn it, then the rest of Dentist likely share the same feeling.

And like I stated someone has to train these therapist to do these procedures and as of now only Dentist do them so Its likely in the Dentist control whether this goes through or not.

I think this is an interesting question about who will train Dental Therapists. Obviously dental therapy schools, but specifically who within those schools? I do not think filling a crown or extracting a tooth can be taught in a cookbook like fashion. It takes experience professionals (ie. dentists) with experience to teach and monitor the development of such skills.

 

[sacapuntas]

I have talked to dentists in MN that plan to hire DT's rather than associates over the next few years. They cited research that shows DT's are capable of practicing within their scope and that scope seems more appropriate to complement a small practice than another dentist does. Also, the DT is more likely to be satisfied to make a career of working with the dentist rather than an associate who is likely going to move on as soon as he/she feasibly can.

 

[Blue87Fiero]

I have got a great idea to address the problem of areas that are undeserved. Why don't we train some people to basic dental procedures and send them to these undeserved areas where there will be a lack of specialist and other dentist. Something tells me this will end with root tips left in extractions and root canals with unfilled canals....ect.

Why not make incentives for dentist that have done GPR or AEGD to go to these areas? I think someone with more experience would be a MUCH smarter decision. Something tells me this is the result of politicians and not dentist

 

[Blue87Fiero]

I have talked to dentists in MN that plan to hire DT's rather than associates over the next few years. They cited research that shows DT's are capable of practicing within their scope and that scope seems more appropriate to complement a small practice than another dentist does. Also, the DT is more likely to be satisfied to make a career of working with the dentist rather than an associate who is likely going to move on as soon as he/she feasibly can.

I can see this I just don't think that dental therapist are the answer to getting dental care to the underserved areas

 

[NDPitch]

If the government really wants to get its hand on dentistry and pass DT legislation, why don't they instead work with the ADA to determine specific areas that are deemed to be officially under served. Then, give rewards to the dentist that practices there, through tax breaks on the practice, and/or personal income. Or offer loan payback assistance, which would essentially just be a monthly stipend that could be used towards loan payments. I still don't see the need to create a new position in the US. It is not a matter of providing quality care, we already do that. We just need to get the quality care into the areas that need it. Rewarding dentists for doing so is the solution.

 

[KillaCam]

I am so against DTs it's not even funny.

My main concern/question is this: Who are the ones really at risk for the implementation of DTs? My answer would be first and foremost the patients. It's clear that the dental access-to-care problem in these isolated and rural areas within California/Alska/Minnesota need some serious attention to ensure that more and more people are getting adequate care. What is adequate care? Care that is both available (in quantity) and, more importantly, QUALITY care. In short, Dental Therapists do not receive near the amount or QUALITY of training as dentists do. People can enter these programs straight out of high school with no education and no real thinking required. The art of dentistry is not synonymous with a tooth technician; we are well-trained professionals that undergo a much more rigorous training curriculum so we learn the ability to diagnose and treat the underlying problem within the scope of dental practice. Even after 4 years of extensive trainingin dental school, most do practice residencies in order to better develop the skills necessary to provide the high quality standard of care we as dentists are expected to provide. So how are Dental Therapists going to be able toprovide the same quality of care when their training time frame and amount of awareness of overall systemic health is severely reduced to a level most definitely not compatible with that of licensed dentists today? The answer to this problemis simple: The quality of care is less than what a licensed dentist can provide.

If the access-to-care issue is really a big issue here and the premise that some care (although of definite lower quality) is better than No care, than DTs should ONLY be allowed to practice within these areas and there must be a system set in place to in fact overlook the distribution of DTs within these DT accdepting states.

 

[pantzed]

I am so against DTs it's not even funny.

My main concern/question is this: Who are the ones really at risk for the implementation of DTs? My answer would be first and foremost the patients. It’s clear that the dental access-to-care problem in these isolated and rural areas within California/Alska/Minnesota need some serious attention to ensure that more and more people are getting adequate care. What is adequate care? Care that is both available (in quantity) and, more importantly, QUALITY care. In short, Dental Therapists do not receive near the amount or QUALITY of training as dentists do. People can enter these programs straight out of high school with no education and no real thinking required. The art of dentistry is not synonymous with a tooth technician; we are well-trained professionals that undergo a much more rigorous training curriculum so we learn the ability to diagnose and treat the underlying problem within the scope of dental practice. Even after 4 years of extensive trainingin dental school, most do practice residencies in order to better develop the skills necessary to provide the high quality standard of care we as dentists are expected to provide. So how are Dental Therapists going to be able toprovide the same quality of care when their training time frame and amount of awareness of overall systemic health is severely reduced to a level most definitely not compatible with that of licensed dentists today? The answer to this problemis simple: The quality of care is less than what a licensed dentist can provide.

If the access-to-care issue is really a big issue here and the premise that some care (although of definite lower quality) is better than No care, than DTs should ONLY be allowed to practice within these areas and there must be a system set in place to in fact overlook the distribution of DTs within these DT accdepting states.

http://thatschurch.com/wp-content/uploads/2012/09/tumblr_maq77ecMHG1qejf6u.gif

REVOLT!!!!

 

[thewingman]

If you are concerned, then donate to ADPAC

http://www.ada.org/2037.aspx

 

[suarez 7]

I am so against DTs it's not even funny.

My main concern/question is this: Who are the ones really at risk for the implementation of DTs? My answer would be first and foremost the patients. It’s clear that the dental access-to-care problem in these isolated and rural areas within California/Alska/Minnesota need some serious attention to ensure that more and more people are getting adequate care. What is adequate care? Care that is both available (in quantity) and, more importantly, QUALITY care. In short, Dental Therapists do not receive near the amount or QUALITY of training as dentists do. People can enter these programs straight out of high school with no education and no real thinking required. The art of dentistry is not synonymous with a tooth technician; we are well-trained professionals that undergo a much more rigorous training curriculum so we learn the ability to diagnose and treat the underlying problem within the scope of dental practice. Even after 4 years of extensive trainingin dental school, most do practice residencies in order to better develop the skills necessary to provide the high quality standard of care we as dentists are expected to provide. So how are Dental Therapists going to be able toprovide the same quality of care when their training time frame and amount of awareness of overall systemic health is severely reduced to a level most definitely not compatible with that of licensed dentists today? The answer to this problemis simple: The quality of care is less than what a licensed dentist can provide.

If the access-to-care issue is really a big issue here and the premise that some care (although of definite lower quality) is better than No care, than DTs should ONLY be allowed to practice within these areas and there must be a system set in place to in fact overlook the distribution of DTs within these DT accdepting states.

While I am against dental therapists, there have been numerous studies done on the efficiency/quality of dental therapists. We should really end the subjective attitude towards them because it's going nowhere.

http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&itemId=311955&wf=1366
http://www.drbicuspid.com/user/docu...6_Nash_Dental_Therapist_Literature_Review.pdf

These studies suggest that despite their rapid training, they are adequete in their scope of practice. There may be question about who's funding these studies, but pre-dents/dental students/dentists need to be aware of these studies and continue to support the ADA's fight against a midlevel provider. Otherwise, they are just getting forwarded to the desks of politicians who make the laws despite not knowing the real issues.

 

[Stacker]

I've had a hard time quantifying how much education and training is enough education and training for a safe dental practitioner. We can always argue how one professional has more experience than another but exactly how much experience is considered sufficient for an individual to practice without supervision? Dental therapists (DT) have proven efficacy in many foreign countries by centralizing the use of DTs within public school clinics. I would be more open to the use of DTs if we were some how able to measure the procedural success rate of DTs, considering their respective education, with that of dentists and hygienists. If it is reasonably within the margins with that of dentists, I'd openly receive them in my state. Also at what point would the "quality of care" become unnoticeable?

 

[goffdent]

The bigger push is for an advanced hygiene degree in many states, and the ADA is pushing hard to avoid this. One thing you have to know is that they cannot perform root canals, crowns, birdges, dentures, perio surgery, many can't prescribe, or at least prescribe narcotics. They can due "simple" extractions, restorations, cleanings, x-rays. Their scope is very limited. It's the essentials to get by. They also won't be paid what a dentist is paid, and many of them will have to work in rural locations, but the transition could be to urban and inner city clinics as well. The thing is that.. if a dentist hires one, he might treat more medicaid patients, which opens the access to care problem.

 

[Blue87Fiero]

If the government really wants to get its hand on dentistry and pass DT legislation, why don't they instead work with the ADA to determine specific areas that are deemed to be officially under served. Then, give rewards to the dentist that practices there, through tax breaks on the practice, and/or personal income. Or offer loan payback assistance, which would essentially just be a monthly stipend that could be used towards loan payments. I still don't see the need to create a new position in the US. It is not a matter of providing quality care, we already do that. We just need to get the quality care into the areas that need it. Rewarding dentists for doing so is the solution.

They do have something kind of like this.

http://nhsc.hrsa.gov/loanrepayment/