Dental Therapists Reduce Inequalities – North American Experience
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- Published: Wednesday, 04 December 2024 11:24
- Written by Peter Ingle
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“So why it is that children—some children—experience higher rates of tooth decay, and more importantly, what we can do about it? “
The question was posed by Donald Chi, professor and associate dean for research at the School of Dentistry at the University of Washington in Seattle. He is also a board certified paediatric dentist.
In a conversation with SciLine, professor Chi offered his answers, which offer encouragement to those hoping that increased use of dental therapists can reduce inequalities in the UK.
Low-income individuals have difficulty finding and accessing dental care. Even within that group, some may experience even greater challenges trying to get dental care. Professor Chi mentioned racial and ethnic minorities, individuals with disabilities or special health care needs, and individuals who might live a long distance away from a dental practice.
The professor was asked to explain who dental therapists were and what they did. It should be emphasised that he was speaking of the situation in the USA. He said: “Dental therapists are a lot like physician assistants. They’re not full-fledged dentists, but they’ve received enough training to provide a limited scope of dental care procedures. So dental therapists typically will get anywhere from two to four years of training after high school, and they’re trained to provide preventive care.” He added: “I think that there is a lot of language out there to suggest that dental therapists are mini dentists, and they’re not. They have a very limited scope of practice, but that scope of practice is really important because what it allows dental therapists to do is to put out small fires in a community with lots of dental care needs, and so then the dentist can come in and put out the big fires. And so really, it’s a team-based effort where dental therapists are working with dentists to make sure that all of a community’s needs are met.”
Alaska was the first state to authorize dental therapists in 2006. Asked about their impact on access to care in the tribal community, Professor Chi said: “What we essentially found is that Medicaid recipients, they were less likely to have teeth removed. So this is both children and adults. They were less likely to have extractions, which meant that more people were keeping their teeth longer and they were also more likely to get preventive care, so care like fluoride treatment and cleanings.”
Asked what other lessons had been learned from other states that have authorized dental therapists, he said that those on Medicaid, who are low-income publicly insured individuals, are more likely to get into the dentist and more likely to receive dental care. The programmes are relatively new, while in Alaska, dental therapy has been around for nearly 20 years, the rest of the states have been running their schemes for much less time. The example was given of Minnesota, where Minnesota Medicaid users are more likely to visit a dental office and get dental care since dental therapy was introduced. There were similar types of outcomes in other states.
Professor Chi was asked about ways that people can promote good oral health, aside from visiting a practice or clinic, and spoke about the importance of diet and fluoride.
In one contrast to the direction of travel in the UK, he added that it was still “important to get to the dentist every six months,” whether seen by a dental therapist or by a dentist.
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