NY Times at it again

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After two years of intensive training, the therapists are allowed to perform routine tooth extractions and fill cavities. You only need a high school equivalency to attend this two years program, saving six years of your college/dental school and half a million $$$. Either the dental schools are ripping us off big time or the government is insulting us big time.
 
Here are my random thoughts in no particular order...
What happens when this spreads down here to the 48?
Hygenists have to have a college degree don't they?
They are taking high school (and GED)kids off the street and sticking drills in their mouths!
Are they using any other pain control besides laughing gas?
 
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"But some dentists in public health programs contend that dentists in private practice consider therapists low-cost competition"

SOME DENTISTS??! Of course they do! They don't need 4 years of college or 4 years of dental school. They don't even need to spend $200,000 on dental school. Why would anyone see a dentist when the local therapist could do fillings for them? The therapist doesn't have half the costs, and a lot of this is simply from decreased requirements in the education and business.

I think a lot of this also has to come from the fact that most people don't perceive dentists as doctors. Time and time again I've heard people say "dentists have to go through how many years of school?" "Oh, so you're like a doctor then?" and it frustrates me immensly. People think that dentists are just ripping them off, or as one guy told me, we have a "license to steal". That also frustrated me because dentists work hard, very hard for their money and they also have tons of overhead and loans they need to pay. It's not that we aren't making good money, but that people don't understand why dental work is so expensive.
 
I'm pretty discouraged to read this article. I have spent quite a bit of time in Unalakleet and the Alaska bush. I have always enjoyed my time in Unalakleet. I was under the impression that dental therapists were only working in the native villages, but apparently this is not the case. Unalakleet is NOT a native village. It is a town, and it is mixed. It has an economy and it is NOT poor. The New York Times really misrepresented the place.

This is a disgrace to the profession. What I will not argue with is the need for dental care in the Alaska bush. You would not believe the amount of junk food these people eat. It honestly would not suprise me if 1/4 the air frieght by weight in the Alaska bush was soda. They drink it almost exclusively. There is very little value placed keeping a nice smile, and preventive care is very poor. The reason they can't afford care is that half of them need full mouth reconstruction. The whole lifestyle in rural Alaska is enough to make any health professional cringe.

What really blows my mind is how this only requires a 2-year education. It probably covers about as much material as 1 year of dental school, as I doubt it is very academically challenging. There is just no way these people are qualified to be making diagnosis and doing irreversable procedures.

The great irony is that Alaska doesn't even subsidize DDS education. They participate in WICHE, but only by providing extra loans. Yet they will foot the bill for the dental therapist program (with federal money), and the best part is the students even get a monthly stipend! "All seven had quit full-time jobs and must now get by on a $750 monthly stipend during the two years of training." WOW, WHAT A SACRIFICE.
 
makushin said:
I'm pretty discouraged to read this article. I have spent quite a bit of time in Unalakleet and the Alaska bush. I have always enjoyed my time in Unalakleet. I was under the impression that dental therapists were only working in the native villages, but apparently this is not the case. Unalakleet is NOT a native village. It is a town, and it is mixed. It has an economy and it is NOT poor. The New York Times really misrepresented the place.

This is a disgrace to the profession. What I will not argue with is the need for dental care in the Alaska bush. You would not believe the amount of junk food these people eat. It honestly would not suprise me if 1/4 the air frieght by weight in the Alaska bush was soda. They drink it almost exclusively. There is very little value placed keeping a nice smile, and preventive care is very poor. The reason they can't afford care is that half of them need full mouth reconstruction. The whole lifestyle in rural Alaska is enough to make any health professional cringe.

What really blows my mind is how this only requires a 2-year education. It probably covers about as much material as 1 year of dental school, as I doubt it is very academically challenging. There is just no way these people are qualified to be making diagnosis and doing irreversable procedures.

The great irony is that Alaska doesn't even subsidize DDS education. They participate in WICHE, but only by providing extra loans. Yet they will foot the bill for the dental therapist program (with federal money), and the best part is the students even get a monthly stipend! "All seven had quit full-time jobs and must now get by on a $750 monthly stipend during the two years of training." WOW, WHAT A SACRIFICE.
Click to expand...

thanks for enlightening us. it shows you that the media is bias on what they write and you can't always trust them.
 
I swear that the NYT has an agenda against dentistry. This is like the 3rd anti-dentistry article in 2 years.

You can bet that your politicians are reading this too.
 
Taurus said:
I swear that the NYT has an agenda against dentistry. This is like the 3rd anti-dentistry article in 2 years.

You can bet that your politicians are reading this too.
Click to expand...

I agree. I know somebody said the worst part is about the stipend... that was bad but I think this is worse:

"She slipped a drill into Paul’s mouth and bore into one of his cavities, then laid down a filling of silver amalgam. A few minutes later, Paul stood from the chair, smiling broadly."

The problem with this statement is that it is succinct, oversimplification and degrading of what our practice entails. It's this philosophy that a lot of patients have when coming to dentists in practice that state, "but doc, can't you just put some of that epoxy plug into the hole so I can worry about it later?"

As said hundreds of times in dental school... you can teach a monkey how to do these preps, but that's not the only reason why you spend four years in dental school. You are taught how to be a clinician, a doctor, a teacher of principles.

Public health practices rarely focus upon teaching, rather they focus on filling and removing teeth. Give these therapists and hygienists the title doctor if that makes them feel better. Maybe that will make them feel better about themselves, make the politicians pat themselves on the back thinking they accomplished something great, and make the NY Times editors feel better about themselves because their journalism style is "working". Just don't allow them the scope of what dentists do.

Any practicing dentist can't even count the number of times "easy" fillings turn into crowns / endo or "easy" extractions turn into surgical sectioning, buccal flaps, suturing, etc.

I work in a public health style facility that has a 3-4 month waitlist and I'd love to have an easy path for other dentists or mid-level practitioners to come and help. I do, however, support RIGID guidelines on where they can practice... i.e. working WITH ME under MY DIRECT SUPERVISION at a public health facility that is indirectly or directly supported by state or federal government performing basic needs-level care to people who absolutely cannot afford it. Working at a ritzy mall somewhere providing whitening, cleanings, or "kiddie fillings" does not classify as helping the greater public need.... now in rural Alaska is a different story.

I can attest to the skill level of some EFDAs I worked with at the Indian Health Service in remote North Dakota. Some of them are great at fillings... but I watched them again and again ignore basic principles of dentistry because they are so far inside the box because they are not trained to think outside.

It's also important to realize that what works in rural Alaska does not work in rural America. Some of you may know that I work in the FL Keys... we are classified as a rural, underserved county in the state of FL. I can see dental therapists setting up on Duval street in Key West doing fillings on staff members of Cruise ships and tourists from Europe... because that certainly politically will serve the public need.

The truth of the matter is that so many people who are involved with this process are against it but simply go along with the status quo because it is simpler and easier for their own personal political futures.

-Mike
 
I have good news! The New York Times has been suffering horrible circulation decrease and ad revenue decrease and laying of a lot of their leftist punks. Good riddance.
 
shizam09 said:
http://www.nytimes.com/2008/04/28/business/28teeth.html?hp:
Click to expand...

Now you guys in dentistry know what we've been dealing with in medicine. NPs are encroaching on primary care medicine and with the Doctor of Nurse Practice degree now being touted by nursing schools, it's only a matter of time till DNPs start advocating for surgical training, etc.

Optometrists want to do ocular surgeries and prescribe oral meds without restriction. PTs want direct access to patients, order and interpret MRIs, CTs, and x-rays. PhD/PsyD psychologists want prescriptive authority for psychotropics. CRNAs want full anesthesia authority without MD/DO supervision. It's never-ending.

In time, the RDHs will want a Doctor of Dental Hygiene degree. After all, it's being tossed around in the PA community for a Doctor of Physician Assistant degree for PAs.
 
only needing a high school diploma or equivalency is INSANE...there just isnt enough time in a two year program to teach someone at a high school level an acceptable amount of advanced coursework and a decent amount of practical experience to be able to perform irreversible procedures. This is definitely a slap in the face to dentistry and what it really entails to effectively practice the profession. ridiculous...
 
Makushin, why don't you consider sending your response to the editors at the NY Times? I think you're in a position to provide a good rebuttal.
 
Jaylee777 said:
only needing a high school diploma or equivalency is INSANE...there just isnt enough time in a two year program to teach someone at a high school level an acceptable amount of advanced coursework and a decent amount of practical experience to be able to perform irreversible procedures. This is definitely a slap in the face to dentistry and what it really entails to effectively practice the profession. ridiculous...
Click to expand...

True, this is so undermining the dental profession in this country. It's like making a fool out of all the dentists and dental school students that have invested all that time and money and effort. Since politicians would be reading this article, I'd like to ask them, "Do we even need any dental schools in the U.S.?"
If they think that a high school diploma and a 2 year program is all it takes to do dental work, why don't they just close down all the dental schools and start setting up these tech schools nation wide so we could hurry up and solve this dental access crisis!
 
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makushin said:
I'm pretty discouraged to read this article. I have spent quite a bit of time in Unalakleet and the Alaska bush. I have always enjoyed my time in Unalakleet. I was under the impression that dental therapists were only working in the native villages, but apparently this is not the case. Unalakleet is NOT a native village. It is a town, and it is mixed. It has an economy and it is NOT poor. The New York Times really misrepresented the place.

This is a disgrace to the profession. What I will not argue with is the need for dental care in the Alaska bush. You would not believe the amount of junk food these people eat. It honestly would not suprise me if 1/4 the air frieght by weight in the Alaska bush was soda. They drink it almost exclusively. There is very little value placed keeping a nice smile, and preventive care is very poor. The reason they can't afford care is that half of them need full mouth reconstruction. The whole lifestyle in rural Alaska is enough to make any health professional cringe.

What really blows my mind is how this only requires a 2-year education. It probably covers about as much material as 1 year of dental school, as I doubt it is very academically challenging. There is just no way these people are qualified to be making diagnosis and doing irreversable procedures.

The great irony is that Alaska doesn't even subsidize DDS education. They participate in WICHE, but only by providing extra loans. Yet they will foot the bill for the dental therapist program (with federal money), and the best part is the students even get a monthly stipend! "All seven had quit full-time jobs and must now get by on a $750 monthly stipend during the two years of training." WOW, WHAT A SACRIFICE.
Click to expand...

What is that woman doing outside of those native villages?!?
Does the Alaska gov or the judge that ruled in favor of these dental therapists instead of the greedy ADA, even know where these quacks are practicing dentistry?
Now the whole nation can see and this article proves that quacks are absolutely no different from the greedy dentists that don't want to work in some cold village without Walmart around the corner. I hope a we could catch a few more of those quacks out of the native villages so that we could use as evidence in other cases such as in the ADHP/OHP in MN that quacks are no different.
Makushin, I agree qith OffAngleHatchet in that you are in a good position to send a letter or email to the Alaskan gov and NYT. I also think we should send a letter to the editor of this article. People nationwide read the NYT and by casualing introducing these quacks to the public like this as another option to dentists it is kind of like indirectly showing approval that these quacks are good enough as traditional dentists. I doubt any immediate changes would be made through the email, however, educating and informing the legislatures and editors through such examples could be a great way to prevent future disasters.
 
Why don't they just train these people as dentists???
 
Right out from high school? ugg
How many schools are actually offering this dental therapy degree?
 
While I do agree that "dental therapists" can help the need for greater dental care coverage in rural, isolated areas, I absolutely disagree with the fact that only a high school diploma is required. I know when I graduated high school, I was not mature or disciplined enough to go straight into dental school, which is kind of what that program is doing. I am not saying that the dental therapy program is comparable to dental school...simply that I would not trust a high school grad to go anywhere near me with a hand drill.
 
mikey4226 said:
While I do agree that "dental therapists" can help the need for greater dental care coverage in rural, isolated areas, I absolutely disagree with the fact that only a high school diploma is required. I know when I graduated high school, I was not mature or disciplined enough to go straight into dental school, which is kind of what that program is doing. I am not saying that the dental therapy program is comparable to dental school...simply that I would not trust a high school grad to go anywhere near me with a hand drill.
Click to expand...

I didn't even want to go to dental school until my third year in college, and that was only because my gf attended dental school. The idea may backfire as more people realize that a high school grad is messing inside their oral cavity.
 
mikey4226 said:
While I do agree that "dental therapists" can help the need for greater dental care coverage in rural, isolated areas, I absolutely disagree with the fact that only a high school diploma is required. I know when I graduated high school, I was not mature or disciplined enough to go straight into dental school, which is kind of what that program is doing. I am not saying that the dental therapy program is comparable to dental school...simply that I would not trust a high school grad to go anywhere near me with a hand drill.
Click to expand...

I hope for your sake that you didnt graduate HS at age 40+. These newly trained dental therapist aren't immature fresh out of HS teenagers.

Also can anyone really blame the media for oversimplifying what dentists really do. If anyone is to blame its dentists and the ADA themselves. For those of use hoping to graduate in a few weeks, ask yourself how concerned were any of us with basic public health practices as graduation approached. The fact is most schools restoratively driven...i.e. how many and how quickly can requirements be completed.
Dental therapist likely dont get anywhere near the same level of basic science and medicine training related to dentistry. But once those courses are completed in dental school how many of your clinical intructors ever gave a comprehensive assessment of a patients medical history. For many all they want to know is if epi is contra-indicated. If something seems unusual or suspicious on a patient hx, a medical clearance is usually requested, which can be interpreted as "all I need to know is can I do a filling on this patient." Remember how you felt when you passed biochemistry or physiology and the preception of never needing to recall that information again. Its those feelings that also contribute to the misconception of dentist not being considered real doctors.

I'm not suggesting that dental therapist be given the same latitude or independence as someone's who has undergone 3plus years of ADA accredited dental school training. However with appropriate oversight these programs have been utililized successfully around the world for years. Hopefully initiatives like this can prevent another Deamonte Driver situation from occuring. Whats occuring in Alaska may not ideal but its better than doing nothing at all...
 
MrVagus said:
I hope for your sake that you didnt graduate HS at age 40+. These newly trained dental therapist aren't immature fresh out of HS teenagers.

Also can anyone really blame the media for oversimplifying what dentists really do. If anyone is to blame its dentists and the ADA themselves. For those of use hoping to graduate in a few weeks, ask yourself how concerned were any of us with basic public health practices as graduation approached. The fact is most schools restoratively driven...i.e. how many and how quickly can requirements be completed.
Dental therapist likely dont get anywhere near the same level of basic science and medicine training related to dentistry. But once those courses are completed in dental school how many of your clinical intructors ever gave a comprehensive assessment of a patients medical history. For many all they want to know is if epi is contra-indicated. If something seems unusual or suspicious on a patient hx, a medical clearance is usually requested, which can be interpreted as "all I need to know is can I do a filling on this patient." Remember how you felt when you passed biochemistry or physiology and the preception of never needing to recall that information again. Its those feelings that also contribute to the misconception of dentist not being considered real doctors.

I'm not suggesting that dental therapist be given the same latitude or independence as someone's who has undergone 3plus years of ADA accredited dental school training. However with appropriate oversight these programs have been utililized successfully around the world for years. Hopefully initiatives like this can prevent another Deamonte Driver situation from occuring. Whats occuring in Alaska may not ideal but its better than doing nothing at all...
Click to expand...


You think med school or pharm school students don't feel the same way when they're taking courses like biochemistry or physiology? I bet most of them too probably have an experience of complaining at least once on why they have to memorize loads of materials that they won't ever be using. Not only health professions, but how many majors or professions can you name that teach just the very practical portion that can be utilized for the job?

What offends me the most in this article is the fact that these midleves are practicing outside of the native villages 'already' when it's only been how many years?? 2 or 3 years at the most since the first class had graduated.
Legislators in other states are watching and I assume it will be either one of the two. Either the dental association shows opposition to these kinds of articles on how our profession is being undermined and insulted and prevents this from becoming a national trend, or once this works out well in all of Alaska DTs will spread out nationwide and settle down as an alternative group to dentists.

Yes, DTs are better than nothing but aren't there better options such as GPR or loan forgiveness plans that could resolve this access problem, provide quality care, and not insult the dental profession?
 
An amalgam by a DHAT or ADHP would not have saved Deamonte Driver. Unless he needed a "simple" extraction that one of these DHATs or ADHPs could do, I'd bet money that he needed to be treated by a dentist for the extraction or endo he needed. When I did my GPR, we saw patients come in many times who needed an extraction, balk at the cost of it or act scared about the procedure, and decided it didn't hurt bad enough to get it done. Guess where they showed up 1 week later - at the ER with a severely compromised airway resulting in having to do the extraction in the OR on your tax dollars. DHATs and ADHPs are not the solution to increase "access to care." Anyone who's done a residency can tell you that.
 
I should clarify on the village part. Unalakleet is not a town with Walmart and what not. The population is probably too marginal to support a full-time dentist. (I think there actually was a dentist in town several years ago). And it is indeed mostly natives.

I'm not sure what the definition of village is. However, I do not personally consider Unalakleet a 'village'. I have been to many villages in Alaska. A typical village has very little economy, only a handful of white people, and lives what I would classify as basically a third-world lifestyle, with little value placed on education.

Unalakleet has a large white and 'mixed' population. There exists nice houses, and the average household income is only slightly lower than in my Anchorage suburb. I would feel totally comfortable living in Unalakleet for a few years. I honestly cannot say this about any of the 'real' villages. There is no reason they couldn't have a dentist run a satelite office in this town, they are just bieng cheap.


PS, I guarantee the locals already refer to this woman as "the dentist".
 
MrVagus said:
I hope for your sake that you didnt graduate HS at age 40+. These newly trained dental therapist aren't immature fresh out of HS teenagers.
Click to expand...

Not trying to attack you but I could care less about how old the high school graduate is...sure, being older and more mature is better...but a high school education is the same no matter what age you are. They cant have a real scientific/medical understanding of what they are really doing when they "bore" into cavities off just two years of education which im sure includes a lot of practical experience. I mean, do they even have some sort of entrance exam or any high school grad/GED applicant welcome?

Why not find ways to attract properly trained and qualified individuals to the state or any underserved area for that matter with GPRs and loan forgiveness programs? :idea:
 
Jaylee777 said:
Not trying to attack you but I could care less about how old the high school graduate is...sure, being older and more mature is better...but a high school education is the same no matter what age you are. They cant have a real scientific/medical understanding of what they are really doing when they "bore" into cavities off just two years of education which im sure includes a lot of practical experience. I mean, do they even have some sort of entrance exam or any high school grad/GED applicant welcome?

Why not find ways to attract properly trained and qualified individuals to the state or any underserved area for that matter with GPRs and loan forgiveness programs? :idea:
Click to expand...

To add to this, a high school education in the Alaskan bush is a pretty marginal accomplishment. They are not exactly offering AP biology in these places.
 
Composite A2 said:
Why don't they just train these people as dentists???
Click to expand...

I doubt they would stick around in the Alaskan villages if they actually become dentists. So again, loan forgiveness programs and GPR is the way to go.
 
"It’s neither right or necessary to relegate people who live far away or who are poor and whose lives are different from ours to a lesser standard of care. A.D.A. members are committed to solving access disparities without needlessly shortchanging the most vulnerable Americans."

Mark J. Feldman
President, American Dental Association
Chicago, May 2, 2008


What a stud.
 
makushin said:
To add to this, a high school education in the Alaskan bush is a pretty marginal accomplishment. They are not exactly offering AP biology in these places.
Click to expand...

AP - salmon anatomy.

What high school did you go to? CHS here.
 
Daurang said:
I have good news! The New York Times has been suffering horrible circulation decrease and ad revenue decrease and laying of a lot of their leftist punks. Good riddance.
Click to expand...

I don't think it's a left or right issue. I was suprised to see this article published in the NY times. The guy to wrote the article doesn't speak much of higher education. I'm not sure it's solely his fault becuase if you think about it the general public doesn't know much about dentists either. They should publish another article apologizing for some of the comments they made towards dentists.
I don't care what newspaper you're reading or news chanel you're watching. They all trying to appeal to people who have an education no higher than a fifth grader.
 
jay47 said:
"But some dentists in public health programs contend that dentists in private practice consider therapists low-cost competition"

SOME DENTISTS??! Of course they do! They don't need 4 years of college or 4 years of dental school. They don't even need to spend $200,000 on dental school. Why would anyone see a dentist when the local therapist could do fillings for them? The therapist doesn't have half the costs, and a lot of this is simply from decreased requirements in the education and business.

I think a lot of this also has to come from the fact that most people don't perceive dentists as doctors. Time and time again I've heard people say "dentists have to go through how many years of school?" "Oh, so you're like a doctor then?" and it frustrates me immensly. People think that dentists are just ripping them off, or as one guy told me, we have a "license to steal". That also frustrated me because dentists work hard, very hard for their money and they also have tons of overhead and loans they need to pay. It's not that we aren't making good money, but that people don't understand why dental work is so expensive.
Click to expand...

Yep, I share your concerns. You will hear more of this comming from whinny Med students. Suprisingly, you will hear from our fellow dentists also. A few of those that proceed onto OMS might refer to dentists as "those general dentists". My orthodontist doesn't think she's a dentist because she's an "orthodontist". Some people cannot handle the stigma. Just remember that these folks have some minor problems with their egos that require time to work it out. It's never healthy to be involved in this kind of politics.
 
-"They must also work under the supervision of a dentist, who reviews their work either in their clinics or off-site, by electronically vetting documents and X-rays."-

I think corporate dentistry is really behind this. Why hire a dentist when you can hire 4-5 dental therapists and pay them half as much. All you need is to hire one DR. to review the charts...AND he doesn't even have to be present!

Anyhoo, on a side note the NYT is a great paper. Its just an article. Turn off Rush Dildo and think for yourself.
 
Taxi Driver said:
-"They must also work under the supervision of a dentist, who reviews their work either in their clinics or off-site, by electronically vetting documents and X-rays."-

I think corporate dentistry is really behind this. Why hire a dentist when you can hire 4-5 dental therapists and pay them half as much. All you need is to hire one DR. to review the charts...AND he doesn't even have to be present!

Anyhoo, on a side note the NYT is a great paper. Its just an article. Turn off Rush Dildo and think for yourself.
Click to expand...

1- NYT sucks.

2- I can see your point. Look at what cooperations are doing in Optometry with trying to allow Opticians to do refractions.
 
Taxi Driver said:
-"They must also work under the supervision of a dentist, who reviews their work either in their clinics or off-site, by electronically vetting documents and X-rays."-

I think corporate dentistry is really behind this. Why hire a dentist when you can hire 4-5 dental therapists and pay them half as much. All you need is to hire one DR. to review the charts...AND he doesn't even have to be present!

Anyhoo, on a side note the NYT is a great paper. Its just an article. Turn off Rush Dildo and think for yourself.
Click to expand...
This was a great post until you ruined it with the last sentence. :thumbdown:
 
jay47 said:
"But some dentists in public health programs contend that dentists in private practice consider therapists low-cost competition"

SOME DENTISTS??! Of course they do! They don't need 4 years of college or 4 years of dental school. They don't even need to spend $200,000 on dental school. Why would anyone see a dentist when the local therapist could do fillings for them? The therapist doesn't have half the costs, and a lot of this is simply from decreased requirements in the education and business.

I think a lot of this also has to come from the fact that most people don't perceive dentists as doctors. Time and time again I've heard people say "dentists have to go through how many years of school?" "Oh, so you're like a doctor then?" and it frustrates me immensly. People think that dentists are just ripping them off, or as one guy told me, we have a "license to steal". That also frustrated me because dentists work hard, very hard for their money and they also have tons of overhead and loans they need to pay. It's not that we aren't making good money, but that people don't understand why dental work is so expensive.
Click to expand...

Some dentists? No. All dentists because it hurts your bottom line. This will play out in the dental field sooner or later. I know a guy who works for these big insurance companies, and they are looking to size up dentists too now. It's how oligopoly works. Medicine was the first one to get smacked because people's perception of it being a necessity. So is food.

Make your money in a small town and then say bye-bye to health related fields. The money is drying up eventually. Nurses, therapists, and other tools will run the show for lower costs. Go look at the VA for medicine or dentistry. WOW. Efficient like all the economists say.

And by the way, when did people who look at curves all day figure out what constitutes good care. I know that a lot of therapists can do basic dental work just like nurses can check the BP for me, but somehow the knowledge base is the same.
 
I think I'd like to hire a couple of these therapists and pay them peanuts. Then I can play golf and surf all day long.
 
I think the only way to off set corporates would be by getting more into group practices+ not hiring the midlevels. Dentists need to continuously directly and indirectly educate and indicate to the public and patients on how dentists differ from therapist and the limits of the work that therapist can deliver.
 
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