In an effort to expand access and cut costs to dental care, especially in low-income and rural areas, the 2009 Minnesota legislature allowed the licensing of dental therapists. Minnesota was the first state in the nation to allow the licensing, and eight years later, the experiment seems to be working.
Dental therapists are similar to physician assistants or nurse practitioners in medicine. They are midlevel providers that deliver routine and preventive restorative care such as filling cavities, placing temporary crowns and extracting badly diseases or loose teeth. With a narrower scope of work, dental therapists become experts in these practices while freeing up dentists for other tasks.
The St. Cloud Times reports that benefits of the licensing happened as soon as the first class of dental therapists began graduating in 2011. Recent studies from the University of Minnesota and the Minnesota Department of Health support the claim. The 2016 University of Minnesota study found that as many as 90 percent of uninsured patients on public assistance were seen by a dental therapist and a 2014 study by the Minnesota Department of Health showed that almost a third of all patients saw a reduction in wait times to get an appointment, especially in rural areas.
Access to dental care for low-income people is a key disparity issue in Minnesota as reported by the Robert Wood Johnson Foundation and others. The state has some of the lowest reimbursement rates for pediatric dental care services in the country, making it unaffordable for many dentists to treat Medical Assistance patients. Only 40 percent of kids on medical assistance see dentists each year. Untreated dental issues can quickly lead to other health problems, making treatment even more expensive and debilitating.
In Massachusetts, with the highest rates of dentists per residents than any other state, there were more than 36,000 visits to emergency rooms in 2014 for “preventable oral health” issues, costing the health care system as much as $36 million, according to an estimate by the state’s Health Policy Commission. The state is now considering a number of bills that would allow dental therapists to practice.
Hiring dental therapists also saves money, Sara Wovcha, executive director of Children’s Dental Service told the Associated Press. Wovcha says a dentist might make an average of $75 an hour for a filling. She said a dental therapist could make about half that much for the same work.
“We as a clinic are saving around $1,200 a week,” Wovcha said. That amounts to about $62,400 a year, or roughly the cost to hire another full-time dental therapist.
The new profession has also resulted in reduced wait times for all patients. According to the Minnesota Department of Health study, almost one-third of all patients saw a reduction in wait times to get an appointment, especially in rural areas. Time with a provider increased by 10 minutes.
“We are not a silver bullet for helping access to dental care, but we are a great tool,” said Christy Jo Fogarty, a dental therapist in Minnesota.
The number of dental therapists is still small; there are only about 70 licensed dental therapists in Minnesota, according to the state health department. There are currently only two programs in the state that produce about 20 dental therapist graduates a year. But demand is high, “I’ve had a posting for dental therapists open for six months,” Wovcha said. “I’m thrilled on the one hand. … I think we need hundreds more dental therapists.”