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"Dental therapists" are helping the less fortunate in Minnesota. Michigan should follow their lead.

Jan 10, 2018

Credit Courtesy of the Michigan Dental Association

I was given a very lovely birthday dinner last year by people who care about me, and while I attempted to put on a good show, I was miserable.

That’s because I had suddenly developed an abscessed tooth, and the next morning experienced all the delights of an emergency root canal. However, I was lucky. I have dental insurance, and was able to pay for that part of the bill that wasn’t covered.  

But nearly a third of Michiganders don’t have any dental insurance at all. If you think this is a problem only affecting older people like me, guess again. According to the Council for Maternal and Child Health, 63% of third graders in the Upper Peninsula have a history of tooth decay. Many third-grade children in Detroit need immediate dental care. I’ve met teachers in Detroit and elsewhere who’ve told me what it is like to try to teach kids with chronic toothache.

There are programs that cover many of them – Healthy Kids Dental and Medicaid – but half of all those children covered don’t receive any dental services. That is, in large part, due to the fact that there are not nearly enough dentists in poor and under-served areas.

There are often not enough doctors either, but that need has partly been met by physician’s assistants and nurse practitioners. But there is no equivalent group of dental paraprofessionals in Michigan. But we now have a chance to do something about that.

Last fall, State Senator Mike Shirkey, a Republican from Jackson, moved to do something.

He introduced a bill that would create and license a new category of “mid-level dental providers,” known as dental therapists. They would be able to do simple fillings and extractions, and work under the supervision of a dentist. They would get either three or four years of university training, be licensed, regulated, and required to periodically update their skills.

The American Dental Association has been lobbying hard against it, as you might expect. But many Democrats support the idea of dental therapists in the belief that they would make things better for the disadvantaged. Many Republicans support the concept as well, because they tend to be against over-regulation. Shirkey himself wrote a column in the Detroit News arguing that “this is an issue of freedom. Why would government stand in the way of letting professionals safely and thoughtfully expand their business models?”

Especially, he argued, “when we know it will also expand access to care?” People in the health provider community agree. Shirkey’s bill was passed by the Senate in October on a remarkably bipartisan vote. It’s now sitting in the House Policy Committee.

Those who care about healthy people and a healthy workforce ought to push their representatives to get this bill moving. It is written, by the way, to require dental therapists to practice only in under-served areas or see mostly Medicaid and uninsured patients.

Amy Zaagman, the executive director of the Michigan Council for Maternal and Child Health, tells me that legalizing dental therapists has made a big difference in Minnesota in terms of dental care for the less fortunate. Ferris State University has expressed great interest in training dental therapists, and helping dental hygiene graduates become therapists as well.

Our lawmakers need to do the right thing.

Jack Lessenberry is Michigan Radio’s Senior Political Analyst. Views expressed in his essays are his own and do not necessarily reflect those of Michigan Radio, its management or the station licensee, The University of Michigan.