Roda: Legislature consideration of dental therapist bill is misguided

I’ve devoted my life to helping people keep their mouths healthy, which helps keep the rest of the body healthy, too. I’ve volunteered time and money to support countless initiatives to extend these benefits to all Arizonans.

Dr. Robert Roda

I’ll support any effort that realistically promises to extend safe, comprehensive oral health care to more people. And, that’s why I oppose a proposal in the Legislature to create a new auxiliary called a dental therapist.

On the surface, the out-of-state groups pushing this idea make it sound good. They say dental therapists would be just like physician assistants or nurse practitioners. They insist these people will spread into the most remote parts of Arizona, working with the underserved. They claim they will get patients out of emergency rooms.

Yet none of their claims stand up to scrutiny. Worse, the additional costs and energy necessary to start up this brand new midlevel provider will distract from far more effective means of improving access to dental care.

This is what the advocates of dental therapy get wrong:

  • Dental therapists are not like physician assistants or nurse practitioners, who earn master’s degrees. A dental therapist could begin performing irreversible surgical procedures — something your more highly trained nurse practitioner cannot do — with only three years of post-high-school education and 400 hours of direct supervision by a dentist. They could pull teeth (a surgery) before many would be of legal age to drink alcohol. None of the handful of states that have approved dental therapy has set its training requirement so low.
  • Dental therapists are not likely to set up shop in remote areas. Minnesota is the only state where dental therapists work among the general population, yet nearly all are based in the Twin Cities. Like any business, they have bills to pay and they make the financial decision to locate where there are enough people to support their bottom line.
  • Dental therapists will not keep people from going to expensive emergency rooms for dental care. Adults who show up at the ER with a toothache go there because they have no money. Last year, the Legislature restored emergency dental benefits for AHCCCS patients. That will do far more to route people with serious issues to appropriate dental care.

Indeed, the very foundation of this proposal is offensive. The advocates want to send poor people with the most serious problems to the least trained professional. They are creating a two-tiered dental health care system, which led Rep. Heather Carter to ask: would you rather trust your teeth to a dentist or to someone who was in high school 3½ years ago?

Should the answer be different if you’re poor?

Arizona should put its efforts into making sure all residents have access to top-quality oral health care. That’s what dentists have been doing for years, with no assistance from the out-of-state groups pushing dental therapy.

In addition to providing millions of dollars in charity care, dentists advocated for and won legislative approval of teledentistry, mobile dental clinics and advanced function dental hygienists. We led the effort to restore emergency dental benefits for adult AHCCCS patients last year, and this year we are again pushing to cover preventive dental care for pregnant women in the AHCCCS program — a provision that is proven to improve outcomes for mother and child.

Let’s keep putting our money and energy into these proven solutions, instead of letting an East Coat special interest group distract us. I urge legislators to vote down this bad proposal.

Editor’s note: Mr. Roda, a Scottsdale endondontist, is president of the Arizona Dental Association

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