Column: Dental therapists enhance care

Mike Shirkey

Despite meaningful efforts to address barriers to oral health services in Michigan, it’s clear that further reforms are needed to ensure appropriate dental care is accessible to all Michiganians.

That’s why my colleagues and I introduced Senate Bill 541 last week, which provides Michigan’s dentists with the opportunity to hire and supervise midlevel dental providers, known as dental therapists.

Millions of Michigan residents don’t have access to basic dental care — including seniors, children in low-income families, people in rural areas, individuals with disabilities and pregnant women. Without access to care, dental issues can lead to life-threatening infections or loss of teeth.

It is not simply a quality of life issue, but one that impacts a wide range of issues such as a child’s attendance and attention at school and employability and productivity for adults.

When people do not receive routine dental care, they often resort to emergency departments for treatment of pain or infection. The Anderson Economic Group found Michiganders made more than 7,000 trips to the emergency room in 2011 for preventable dental conditions and hospitals spent $15 million to triage patients without addressing the underlying problem.

This is an ineffective use of our health care system and an inefficient use of our taxpayer dollars.

Similar to the way a physician assistant is utilized as part of physical health care team, dental therapists could extend the reach of a dental practice. They are highly trained for their very limited scope of practice, which includes preventive and basic restorative care, such as filling cavities.

By delegating well-trained and well-defined procedures to dental therapists, dentists would be able to dedicate their time and attention to more complicated patients.

Minnesota authorized this type of provider in 2009, and since then, dental therapists have successfully expanded care to thousands of people throughout the state, while decreasing wait and travel times for patients and increasing patient satisfaction.

In Minnesota, about half of dental therapists now work in rural areas and the dentists that supervise and employ them rate their technical skills and quality of patient care very highly.

In addition to Minnesota, Maine and Vermont, tribal governments in Alaska, Washington, and Oregon have also licensed dental therapists. More than a dozen other states are considering similar bills.

Michigan should move to be a leader, not a follower.

This legislation does not mandate that any dentist employ a dental therapist. However, a dental therapist cannot work without a supervising dentist. The supervising dentist has full authority over a required written practice agreement detailing exactly what a dental therapist can and cannot do. The dentist importantly retains leadership and oversight of the dental team.

The creation of a midlevel dental provider makes sense from both a public health and fiscal perspective. These providers will help ensure more people have access to dental care, without creating a new government-run health care program and without significant new expenditures from our state budget.

Ultimately, this is an issue of freedom. Why would government stand in the way of letting professionals safely and thoughtfully expand their business models? Why would government prevent individuals from furthering their education to become dental therapists when we know it will also expand access to care?

Dental therapists are a market-based solution that would provide additional access to dental care and allow dentists the option of hiring dental therapists to make a difference in improving the oral health of Michigan residents.

Sen. Mike Shirkey serves Michigan’s 16th Senate district.