Dentistry

Dental Therapists an Answer to Access to Care?

Aurora Johnson, left, a dental therapist, filled cavities for Paul Towarak, 10, in the village of Unalakleet, Alaska. For more involved procedures, Ms. Johnson refers patients to a dentist. Photo courtesy of New York Times

Less training is not an answer. Dentistry is a complex and difficult profession that is MORE than extracting and filling a few teeth.

If the dental therapists must have two years of training, how is that different than a three year program at an American Dental School?

Answer: One year of training

And, that solves access to care or the cost of dental care how?


3 Comments

  • Matt

    In the Army we had a system in place to increase the number of hygienists. It was called the X2 program. Basically, all patients were classified into 2 seperate categories regarding prophy’s. We used PSR’s as a general rule and it basically boiled down to those with PSR’s of 2 or less got an appointment with an X2 and those with PSR’s that had at least 1 or more 3 or greater got a licenced hygienist.

    X2’s did prophy’s all day but were not allowed to go subgingival. Not saying it was the best system around but at least in a socialized medicine system it served its purpose. At least that way the average patient could expect to get 2 cleanings a year.

    X2’s went to a 2 or 3 month school to be certified by the military to do what they did.

    We also had a system in place for Expanded Duties Assistants. I do not recall anything that we used them for other than to place amalgams (the dentist numbed the patient up and removed the decay and defined the preparation and the Expanded Duties Assistant would actually place the Amalgam and adjust the occ contacts). We didnt use them too often but every now and then it was nice when you got behind. Also, the dentists were required to go back and check the restoration and bite. Again, probably not the best system around but it had its purpose in a socialized medicine system.

    I am not so sure though about having some type of training school to allow somebody to place restorations without any type of dentist supervision. Can these people use High Speed Handpieces? Who ensures all the decay is removed? Can they give injections? Who ensures the bite is correct? Without any type of supervision this could get all sorts of messy real quick.

    Than again, anybody with dreams of socializing dental care in America has got to come up with some type of way to increase the numbers of providers (than again, maybe just telling somebody they have universal free dental care compensates with also having to inform them that they have to wait 9 months to get an examination on that tooth that is bothering them today).

    Matt

  • Flap

    Matt,

    I think you have hit the driving force on the head. Government social planners wish to increase the supply of cheaply albeit inadequately trained dental providers in order to affect what is a perceived injustice in the delivery of care.

    Socialized dentistry vs Free Market Private dentistry

    Note how well a socialized system, namely the National Health Service in the UK is fairing?