The Michigan State Senate is now considering Senate Bill 1013 (2016), sponsored by Senate Health Policy Committee chair Mike Shirkey, which would establish the dental therapist classification. Under the legislation, dental hygienists who receive additional education, training, and credentials would be allowed to provide dental services such as fillings.
According to the Pew Charitable Trusts, dentists are unevenly distributed across the state, impairing the ability of rural residents, low-income families, seniors, pregnant women, and children on Medicaid to access dental care and negatively impacting their oral health.
For example, Pew reports that nearly one in 4 Michigan third graders has untreated dental decay, while 60% of Medicaid-eligible children didn’t receive any dental services in 2014. Also, more than 876,000 people in Michigan lived in dental shortage areas, with 76 of the state’s 83 counties including at least one shortage area.
“The measure would help Michigan address critical shortages of dental providers and ensure that more residents receive the care they need,” said John Grant, director of the Pew Charitable Trusts Dental Campaign. “Creating dental therapists is an innovative, cost-saving way to increase access to dental care, especially for children and adults on Medicaid.”
The Michigan Dental Association (MDA), however, does not support the legislation. It acknowledges obstacles to care including transportation and language barriers, underfunded government programs, and inadequate provider distribution. Citing another Pew Foundation report, though, the MDA said Michigan still has the capacity to serve everyone, and a new provider with less training than a dentist is not needed.
Instead of creating a new class of provider, the MDA believes, the best solution would be to more effectively use the 7,500 dentists, 10,300 registered dental hygienists, and 1,700 registered dental assistants already in the state. Senator Pete MacGregor is preparing legislation to improve their utilization and extend their use into underserved areas.
Alaska, Minnesota, Maine, and Vermont allow midlevel dental providers, bridging the gap in services between dental hygienists and dentists. More than 50 countries allow these professionals to practice as well. Currently, Michigan is one of 15 states considering adding these types of providers.
Senate Bill 1013 (2016) would require dental therapists to graduate from an educational program that meets Commission on Dental Accreditation standards and then be supervised by a dentist. Also, dentists would be allowed to expand their practices with dental therapists and have the authority to decide which procedures they would perform.
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