Health Affairs: Expanding Where Dental Therapists Can Practice Could Increase Americans’ Access to Cost-Efficient Care

Health Affairs

Dentist visit

A growing body of research has found that dental therapists provide high-quality, cost-effective treatment and improve access to care for underserved populations.

© The Pew Charitable Trusts

Since 1923, more than 50 countries have improved access to dental care by allowing midlevel providers—frequently called dental therapists—to offer preventive and restorative treatment, primarily in the public sector, including in schools. A growing body of research has found that dental therapists provide high-quality, cost-effective treatment and improve access to care for underserved populations. This article explores the evolution of the dental therapy movement in the United States, where multiple barriers to oral health care have created persistent unmet needs. We examine developments since the 1940s that have led to the authorization of dental therapists in parts of Alaska and in Minnesota, Maine, and Vermont, along with the approval of national accreditation standards for dental therapy training programs by dental educators. We also show how dental therapists might fit within a health care system that is being transformed.

Jane Koppelman is research director for The Pew Charitable Trusts’ dental campaign.

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States Expand the Use of Dental Therapy
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States Expand the Use of Dental Therapy

Midlevel providers help increase access to care

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Dental therapists—midlevel providers similar to physician assistants in medicine—deliver preventive and routine restorative care, such as filling cavities, placing temporary crowns, and extracting badly diseased or loose teeth. As states grapple with provider shortages, especially to serve vulnerable populations, a handful have acted to allow dentists to hire these practitioners, and many others are exploring the option. Dental therapists also practice in several tribal communities, where access to care can be especially limited.

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Midlevel providers are helping dentists increase access to care.

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Another type of provider is helping dentists in private practice and public health settings address the gaps in access to dental health care that many Americans face.

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