CHICAGO (Oct. 5, 2011)—Yesterday, the W.K. Kellogg Foundation released survey results claiming that the majority of Americans support new non-dentist mid-level provider models to address access to care. The survey asked if Americans support or oppose "training licensed dental practitioners to provide preventive, routine dental care to people who are going without care."
"The manner in which the questions were posed may have caused some confusion among the public responding to the survey," says Howard Gamble, DDS, FAGD, president of the Academy of General Dentistry (AGD). "Members of the public may not have been aware that the question was referring to supporting or opposing ‘non-dentist mid-level providers.’ Mid-level providers do not have the same level of education as a dentist; they are non-dentists with as little as two years of post-high school training to perform clinical dental procedures that may be irreversible, on populations with the most complex health conditions, without the direct supervision of a dentist. Therefore, these midlevel providers could be putting the patient’s oral and overall health at risk, and that is a concern to the AGD."
The survey also found that a substantial number of Americans do not have health insurance, do not have a dental home, and cannot afford dental care. The AGD believes that the dental professions—dentists, hygienists, dental assistants, public organizations, and foundations—must find a way to implement proven solutions to improve the oral health of the public, rather than create a new position entirely that may ultimately harm patients.
"Unfortunately, the W.K. Kellogg Foundation has chosen the path of presenting its unproven and likely dangerous political spin of using non-dentists to treat those in greatest need as a viable low-cost and accessible alternative," says Joseph Battaglia, MS, DMD, FAGD, AGD Dental Practice Council chair. "The survey fails to mention that a dental degree provides the minimal competence to practice dentistry. It fails to mention that the breadth of education of a dentist results in judgment that is vitally important to provide for patient care, and that lack of this judgment will increase the likelihood of leaving the patient in worse health than he or she was in. When it comes to oral health, something is not always better than nothing."
The safe and proven solutions are readily available and right at the fingertips of the dental profession; however, finances and support by foundations like Kellogg are necessary to implement them. Proven solutions include student loan repayment programs targeted at serving the underserved; increases in community services, such as transportation and oral health education; improvements to Medicaid; implementation of additional volunteer services programs in impoverished regions, such as those offered by the AGD and AGD Foundation’s Outreach Program; and a stronger public health infrastructure that focuses on establishing "dental homes" under the supervision of licensed dentists.
"It is unethical and unfair for the underprivileged to be relegated to lesser educated professionals than the rest of the American population," says Dr. Gamble. "When it comes to their health, organizations should be working together to create workable and proven solutions needed to improve the health of our fellow Americans."
