New Hampshire Takes Strong First Step to Improve Access to Dental Care and Overcome State's Dentist Shortage

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WASHINGTON – Last week, New Hampshire Governor John Lynch signed into law Senate Bill 284, which enables the state to take a strong first step toward reducing the barriers to dental care. Nearly 60,000 state residents live in areas with a dentist shortage. The new law is expected to improve access to care by expanding the scope of services that dental hygienists can perform after they are certified by the Board of Dental Examiners.

States are considering many solutions to the access problem, including training more dentists, expanding the services hygienists and dental assistants can perform, and creating new types of dental providers. New Hampshire's Senate Bill 284 allows certified public health dental hygienists who work in schools, hospitals, and other public settings—or who deliver care to homebound patients—to perform dental X-rays, offer nutritional counseling and place temporary fillings in teeth. This type of filling is a non-surgical and reversible way to prevent decay from progressing in children, teens, and people with special health care needs until a traditional filling can be placed. The American Academy of Pediatric Dentistry recognizes temporary fillings as a beneficial, short-term technique in dentistry.

The Pew Center on the States provided research and other support for the New Hampshire stakeholders who led the campaign for the law's passage.

"Like every other state, New Hampshire has areas where residents live far from the nearest dentist,” explained Shelly Gehshan, director of the Pew Children's Dental Campaign. “As a result, people with decay may go weeks or even months before getting the treatment they need. Allowing hygienists to install temporary fillings is a way to contain the decay until these patients can find a dentist to install a permanent filling.”

The Children's Alliance of New Hampshire (CANH) was one of the stakeholders that urged legislators to approve Senate Bill 284. “We are pleased to see this measure pass,” said Erika Argersinger, CANH's policy director. “This law is a very important piece of the puzzle, but our state can do even more to show that it takes the access problem seriously. We need to train and license new types of providers, working under the supervision of a dentist, who can bring care to those who need it most.”

The state's access problem is fueled by a shortage of dentists. A 2010 report by the New Hampshire Center for Public Policy Studies noted that four out of 10 dentists were at or near retirement age.

The Pew Center on the States is a division of The Pew Charitable Trusts that identifies and advances effective solutions to critical issues facing states. Pew is a nonprofit organization that applies a rigorous, analytical approach to improve public policy, inform the public and stimulate civic life. www.pewcenteronthestates.org.