Report: Dental therapists can help Michigan

Kathy Hoekstra

Most people would choose a dentist’s chair over the emergency room when it comes to their teeth.

Unfortunately, that’s not always an option. A new report by the Mackinac Center for Public Policy, says in 2011 about 7,000 people in Michigan went to the ER for preventable dental issues, at a cost of almost $8,300 per visit.

Facing continued low Medicaid reimbursement rates and a looming dentist shortage, report authors Michael Van Beek of the Mackinac Center and John Davidson of the Texas Public Policy Foundation, argue that one solution is the use of mid-level dentistry, or dental therapists. These are licensed specialists who are trained to perform a number of dental services such as filling cavities and pulling teeth. Minnesota implemented the nation’s first dental therapist program in 2009. Since then, Alaska, Maine and Vermont have followed suit.

Michigan may not be far behind.

State Sen. Mike Shirkey introduced a bill in June to create a new license for dental therapists. The measure spells out specific training and practice requirements. For instance, a dental therapist must graduate from an accredited dental therapy program, work under the general supervision of a dentist and be limited to places such as licensed hospitals, child health centers and clinics that serve low-income or uninsured patients.

The bill faces strong opposition from the Michigan Dental Association, which questions the quality of service performed by “lesser trained” dental therapists.

Shirkey calls the MDA criticism unfounded.

“Those in opposition, primarily dentists, continue to stand behind the false argument of quality concerns,” the Jackson Republican told Watchdog.org. “Where dental mid levels have long been enabled and deployed, there is no evidence to support such a claim.”

The MDA also says with 7,500 dentists and 10,300 registered hygienists, the state should make better use of the state’s existing dental workforce and programs before launching a new one.

That workforce is not evenly spread across the state.

The U.S. Department of Health and Human Services has identified dental shortage areas in 76 of Michigan’s 83 counties, where just 42 percent of people get the dental services they need. To cover all shortage areas, the state would need another 128 full-time dentists.

In addition, more than half of the state’s dentists are 55 or older and likely to retire in the next 10 to 15 years.

Shirkey is chairman of the Senate Health Policy Committee and plans to bring up this dental reform he bill at the committee’s Oct. 18 meeting. While he said he does not have a read on the level of support in the full Senate, he’s encouraged that the measure has drawn backing from both sides of the aisle.

"This should be an easily bipartisan supported issue,” said Shirkey. “Why government would continue to artificially prohibit people who want to advance their education, training, and skills is beyond me.”

Democratic cosponsor Sen. Rebekah Warren of Ann Arbor said her support stems from the numbers of low-income families in densely populated parts of her district, and others in southeast Michigan who are not getting the oral care they need, largely because of low or no Medicaid reimbursement.

“And that’s just not acceptable when we have the tools right here in Michigan, and we see this dental therapist model working in other states,” Warren says. “We need to do something to treat this population.”

Kathy Hoekstra is the regulatory policy reporter for Watchdog.org.