Dental Therapists - Friends or Foe?

[ncamc]

Hello fellow SDNers,

I'm from Maine, and there is currently an interesting controversy going on up here. Legislature is currently considering to allow Dental Therapists to practice in Maine.

For those of you who don't know, a dental therapist is: a healthcare professional who is trained to practice dentistry, That training and practice may include treating the teeth of children and adults, performing local anaesthesia, restorations, cleaning, extractions and the taking of radiographs (wikipedia).

Supporters of the bill feel that dental therapists will aid the underserved residents (especially children) of rural maine

Some folks against the bill (many dentists) feel that the the main root of the problem is education/getting patients to appointments.

Two states already have Dental Therapists practicing (Alaska and Minnesota), but I'm not sure how similar the programs are to the bill in Maine.

Here are some interesting articles about the topic:

Maine House backs dental hygiene therapist bill (written today) -
http://www.ajc.com/news/ap/health/maine-house-backs-dental-hygiene-therapist-bill/nc5H6/

New dental provider won’t improve Maine’s oral health. Prevention, getting to appointments will (written by a Maine dentist practicing in rural Maine) -
http://bangordailynews.com/2014/01/...alth-prevention-getting-to-appointments-will/

Dental Therapists 'Safe' Pulling American Teeth, Study Suggests (PBS) -
http://www.pbs.org/newshour/rundown...crisis-report-finds-therapists-effective.html

Wiki -
http://en.wikipedia.org/wiki/Dental_therapist


What are your thoughts on Dental Therapists practicing in Maine, or anywhere else in the country?
Do you feel that Dental Therapists should be able to carry out fillings, extractions, etc.?
If you have any information on the topic that I neglected, please share!

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[johnho771]

Makes no sense why dental therapists are needed. Wasn't UNE intended to help solve the access to care problem?

 

[nomad12]

Dental Therapists are not needed. Dental Therapists are ONLY a boon to corporate dentistry, who can use them to replace dentists and ram more Medicaid patients or other unsuspecting patients at a higher volume at a lower cost (=$$$$$) and simply have the dentists be the supervising ones to do complex ones and to take the blame if a lawsuit arises. Obviously the educational lobby loves this as well because they will be able to make more and will get that federal student loan grant money from the government. It will not solve access to care.
From the article: "But critics say the problem is the inability of people to show up at appointments, not a lack of access.". This is the reason for no access. This and people spending money on stupid stuff like i-phones and living above their means.

Dental Therapists will be like PAs. Soon they will become as snarly, cantankerous, and obnoxiously pushy and greedy like the CRNA lobby.

 

[briansle]

Hmm.. interesting. Looks like score for kool smiles, small smiles, Church Street Health Management LLC.

Yea sounds like dental therapists will allow corporate dentistry to easily milk the pedo-medicaid pop to the fullest. They'll get the same amount of work done but pay the dental therapists way less so super profits. and the dental therapists will love it.

There's gonna be some serious papoosing going down in the near future. Too bad for the kids.

 

[Daurang]

Yea sounds like dental therapists will allow corporate dentistry to easily milk the pedo-medicaid pop to the fullest. They'll get the same amount of work done but pay the dental therapists way less so super profits. and the dental therapists will love it.

You are absolutely CORRECT.

Another trend to watch for are all these mobile dentistry companies, under the disguise of a formal public health agency, sending therapists and hygienists to grade school to do checkups. They milk only the easy money stuffs like exam/prophy/flouride/sealant. All the necessary xray, perio, endo, restorative, extraction, etc. are ignored or they'll promise they'll return later (which is never!). Your patients return for recall or emergency and you're like 'HUH...WF#!'; your patients said they did stated they already have a dentist but these corporation don't care. Meanwhile, these mobile trucks are busy at the next school, milking more easy money. I highly doubt there's any substantive public health benefits with these dental therapists. It's all about money and connection.

 

[yappy]

I agree with everyone here. It's all about money & power. I have seen too many patients no show for free treatment appointments. The free clinic I was involved with could not even fill its schedule; so, the clinic was always closing early and had multiple no shows!

The access problem isn't a supply side issue; the access problem is that the people who need dentistry want it for free, at cost, or not at all due to their "busy schedules" etc. etc. etc.

Everything wrong with healthcare stems from the premise that everyone must have it. Under false premise many are exploiting tax payers and setting up ridiculous methods for ripping off students, patients, and professionals.

 

[nomad12]

You are absolutely CORRECT.

Another trend to watch for are all these mobile dentistry companies, under the disguise of a formal public health agency, sending therapists and hygienists to grade school to do checkups. They milk only the easy money stuffs like exam/prophy/flouride/sealant. All the necessary xray, perio, endo, restorative, extraction, etc. are ignored or they'll promise they'll return later (which is never!). Your patients return for recall or emergency and you're like 'HUH...WF#!'; your patients said they did stated they already have a dentist but these corporation don't care. Meanwhile, these mobile trucks are busy at the next school, milking more easy money. I highly doubt there's any substantive public health benefits with these dental therapists. It's all about money and connection.

Spot on regarding mobile dentistry. The most disgusting one is ReachOut Healthcare America. The name sounds so innocuous. Thankfully the media is regularly picking up on it. Every dentist needs to start contributing money to the campaign of Senators Chuck Grassley and Max Baucus. Both of these Senators are investigating "whether ReachOut, Church Street and its affiliated clinics have overbilled Medicaid,". Both these Senators have been investigating private equity ventures into dentistry for a couple of years now. Doubt you will hear a word from self-described socialist fool Sen. Bernie Sanders about this. He's the nut who wanted to push that stupid Comprehensive Dental Reform Act. He is a poverty pimp.

(http://www.publicintegrity.org/2013...ds-ouster-large-dental-chain-medicaid-program)

I agree with yappy. It is for reasons like this why I am a fiscal conservative. I want to help the poor, I truly do. But the government taking money from poor and middle class people (taxes) and giving it to large private equity companies (i.e rich CEOs) is really stupid. Unfortunately, the mob of America is so ingrained in this entitlement and naively idealistic attitude (particularly prevalent among the starry-eyed youths of my generation) that they lose all sense of practicality and logic.

 

[ncamc]

Thank you everyone for the input - good stuff.

 

[IsaacYankem]

Interesting stuff. First I'm hearing of this, what kind of training does a dental therapist get? How long has this been a thing?

Echoing the other sentiment, seems like a blatant attempt for corporate chains to maximize profits.

 

[Apollonia]

@ncamc

Here's an update on that topic: http://www.pressherald.com/news/Mai..._but_impact_may_be_minimal_.html?pagenum=full

I live in northern NE and volunteer at a health clinic. From what I gather, the problem is not the shortage of dentists (if there is one). The no-show rate for Medicaid patients is about 50% and the reimbursement rate is too low, as it is the case in most states. I think they should wait until UNE graduates some dentists before trying to pass this nonsense bill.

 

[ncamc]

I'm hoping this won't pass. It doesn't seem even relevant to the issue. In recent years, hygienists in Maine have been allowed to start their own 'practice' for cleaning teeth without a dentist. The idea of this bill was to also help rural/underserved residents up North. However, there are like 3 of these practices now, and they are all in Southern Maine.It seems to me like it's another case of legislatures believing they have more of an understanding of the issues than the actual educated professionals/experts.