Expanding Children's Access to Dental Care: The Minnesota Story
Across the nation, Medicaid-insured children face difficulty in finding dentists who will provide care to them. Public health advocates in Minnesota addressed this access problem by campaigning for a law that would approve the licensing of dental therapists—the dental equivalent of a nurse practitioner. Their efforts culminated in the passage of the law in 2009.
A 2010 brief from the Pew Children's Dental Campaign explained how advocates campaigned successfully for the law, and the lessons this campaign offers to policy makers who want to expand dental coverage to underserved children in their state.
Since the law passed in May 2009, two Minnesota universities have developed a curriculum to train the new dental providers, and each school expects to graduate a dozen new providers in 2011. It's estimated that each dental therapist could serve at least 2,000 patients per year. Recent graduates of Minnesota's advanced dental therapist program share their stories in this video.
From 1993 to 2000, Minnesota's dentist-to-population ratio suffered the greatest decline of all 50 states. In 2008, a state health official reported that roughly 350,000 low-income Minnesotans see a dentist less often than they should or not at all. The lack of access to dental care disproportionately punishes the poor—nationally, children between two and 11 who live below the federal poverty level are twice as likely to have untreated decay compared to their more affluent peers.
The proposed legislation faced strong opposition, spearheaded by the Minnesota Dental Association, which lobbied aggressively against the bill. But advocates in Minnesota built a broad coalition of lawmakers, public health dentists, hospitals, health care providers, oral health educators and nonprofit groups that assist children and the poor. In addition, advocates for the disabled and seniors joined the coalition—recognizing that a new dental practitioner could also expand access to those groups.
The coalition launched an evidence-based campaign, which included support from The Pew Center on the States. Shelly Gehshan, director of the Pew Children's Dental Campaign, testified before the Minnesota legislature about the need for new approaches that would improve access to dental care.