For more than 50 million Americans, finding a dentist is difficult – inside some cases, impossible – proposal. Many rural communities I don’t have a dentist. People of color and people with disabilities they often do not have accessand only about a third of dentists accept Medicaid.
This is why dentists – professionals who do not have a full dental degree but are trained to provide basic dental care – are becoming increasingly popular. Dentists are now licensed to practice in 14 statesand focus primarily on underserved populations.
Dr. Donald Chia pediatric dentist and professor of oral health sciences at the University of Washington, explains the type of training dental therapists receive, their critical need across the US, and how they have impacted the communities they serve.
The Conversation has partnered with SciLine to bring you highlights from the conversation, edited for brevity and clarity.
Who doesn’t have adequate dental care in the US?
Donald Chee: People with low income often have difficulties finding and accessing dental care. This population includes racial and ethnic minorities, people with disabilities or special health care needs, and people in rural areas who live a long distance from a dental office.
What are some of the effects of poor oral health?
Chi: Oral health touches every part of our lives as humans. To eat, socialize, hold down a job and learn, you need your teeth and you need them to be healthy.
Painful cavities can prevent you from sleeping, chewing your food, and working. Imagine you were missing teeth in the front of your mouth because you had them removed due to large cavities. There are numerous studies showing that people are missing their front teeth unable to find or keep jobs. Both the pain and aesthetic aspects of poor oral health can really create problems.
What are dentists, what training do they receive and what services do they provide?
Chi: Dentists are very similar to physician assistants. They are not full dentists, but they have received enough training to provide a limited set of dental procedures. Dentists typically receive two to four years of training after high school, and they do trained to provide preventive care.
Dentists can also administer cleanings and fluoride treatment sealantsi.e. coatings that protect your teeth from bacteria. And they can do some relatively simple procedures – for example, small fillings and simple tooth extractions. But dentists are still needed for more complex treatments: larger fillings, complex tooth extractions, root canals, crowns and dentures.
Dentists do not replace dentists. Dentists have a limited scope of practice, but this scope is critical.
In a community with many unmet dental care needs, dentists can put out small fires. Dentists can then focus on putting out the big fires. It’s a team effort – dentists work with dentists to make sure all the needs of a community are met.
In 2006, Alaska became the first state to license dentists. What did your research reveal about how the Alaska Plan worked?
Chi: What we found is that Medicaid recipients, both children and adults, were less likely to have teeth removed after being approved by dentists. This meant that more people kept their teeth longerand were more likely to receive preventive care such as fluoride treatment and cleanings.
What other lessons have you learned from other states with dentists?
Chi: The rest of the 13 states that have licensed dentists have dental treatment programs that have been in operation for less than 20 years, which is how long Alaska’s program has been running.
But we have seen data from Minnesota showing that Medicaid enrollees were more likely to receive dental care after the introduction of dental treatment. And we see similar types of results in other areas served by dentists. To see this almost immediate impact was just remarkable.
Besides visiting the dentist, what other ways can people promote good oral health?
Chi: Healthy diet is a great way to promote oral hygiene, maintain tooth enamel and reduce the chance of gingivitis.
I realize that eating healthy can be difficult due to the limited availability and relatively high cost of healthy food. But minimizing the amount of sugar in your diet and avoiding sugary juices and drinks are both good ways to protect your teeth.
Brushing twice a day with a toothpaste containing fluoride and drinking fluoridated water will also maintain good oral health.
Watch it full interview to hear more.
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