A hot topic for the Ohio Dental Association (ODA) right now is Senate Bill 98, sponsored by Sen. Peggy Lehner (R-Kettering) and Sen. Cecil Thomas (D-Cincinnati). The legislation provides for the introduction of a “dental therapist” role within the state of Ohio. The intention is to help meet the dental needs of people in many of Ohio’s rural counties.
Straight out of high school students would be able to apply for dental therapy educational programs and graduate after three years with a license allowing them to provide irreversible dental services like tooth removal and preparation (drilling) to remove decay.
Speaking for the ODA, President Dr. Kevin Laing, a general dentist from Van Wert, said, “Allowing undertrained individuals to perform irreversible surgical procedures puts Ohio’s most vulnerable patients at risk.” In addition Laing voices concern that “a dental therapist would create a tiered level of care, where only those who are able to afford it could receive the high quality care of a dentist. We believe that all Ohioans deserve to receive the same level of comprehensive care that a dentist provides, and Ohio dentists have already been making strides to improve access to care to Ohioans in need.”
As with all issues there is an alternative voice. “We are not a silver bullet for helping access to dental care, but we are a great tool,” says Christy Jo Fogarty, a former Minnesota dental hygienist but now one of that state’s 60+ dental therapists. “We have kids who don’t have to go to an emergency room for a toothache anymore.” In 2009 Minnesota became the first state to broadly authorize dental therapists and the educational and training criteria required.
Dental therapists have been at work in the tribal areas of Alaska since 2004. Maine in 2014 and Vermont in 2016 have joined Minnesota in authorizing statewide programs. And Ohio is not alone in the current consideration this issue. Legislation is also under scrutiny in Arizona, Connecticut, Kansas, Maryland, Michigan, New Hampshire, New Mexico, North Dakota and Texas.
As an alternative to dental therapists, the ODA is backing Ohio House Bill 184 to expand access to dental care. “House Bill 184 is important legislation that will allow for the use of state-of-the-art technology in delivering dental care and provides innovative strategies to ensure Ohioans have access to quality dental care,” said Dr. Laing. The bill provides for the use of “teledentistry”, a combination of telecommunications and dentistry to provide for the exchange of clinical information and images across the remote distances to Ohio’s underserved areas. Dental hygienists and expanded function dental assistants would be permitted to provide interim therapeutic intervention following the remote examination and supervision of a licensed dentist.
I don’t know about you, but for me these are thorny ethical issues without easy answers. My personal belief is that it is not ethical for anyone to be deprived of healthcare they need and desire. On the other hand I find a two-tiered standard for care delivery to be equally problematic. If you’ve got strong feelings one way or the other please drop me an email, and be sure to contact your Ohio elected officials. Make sure your voice is heard.
Dr. Davis is especially good with kids. And his staff? Helpful, compassionate, and caring. They take care of business for you. Thumbs up. 10 on a scale of 5.