January 7, 2019

Dental Therapy: A Commonsense Innovation to Fill Gaps in Oral Health Care

This post was last updated on September 29, 2021. As new policies are announced, FPI will update this page.

As Florida’s response to COVID-19 takes front and center, concern grows for low-income families who struggle to take precautions against the spread of the virus. Although Congress has passed the Families First Coronavirus Response Act to address, at least in part,  the public health crisis and economic fallout from COVID-19, many barriers continue to keep struggling families from accessing the assistance they need during the pandemic. As Florida initiates policies implementing the Act and addressing other barriers to the safety net, FPI will update this form. When available, hyperlinks are provided to agency documents or statements that provide greater detail  about the new policy.

On March 22, 2020, FPI and 44 other organizations sent a letter to Governor DeSantis, leadership in the Legislature and agency heads to urge action on 47 specific policy changes to reduce unnecessary barriers for Florida’s safety net programs in response to the COVID-19 pandemic. See the letter here.

As in previous sessions, the 2019 Legislature will likely consider proposals to authorize a new category of oral health practitioner – “dental therapists.” These practitioners already exist in Minnesota, Maine, Vermont, Oregon and Washington, and multiple other states are considering adding them to the oral health workforce.

Dental therapists provide routine preventive and restorative care services such as filling cavities or placing temporary crowns. They are hired and supervised by dentists and able to practice outside of dental offices in community-based locations.

A comprehensive report from the James Madison Institute reviews the research and highlights the multiple benefits of adding dental therapists to the workforce, including:

  • Increased access to care for underserved populations, including low income, the uninsured, rural residents and older adults.
  • Improved oral health outcomes in underserved communities.
  • Reductions in wait times and travel time.
  • Improved patient satisfaction.
  • Dental practice cost savings, increases in average monthly revenue and increased productivity.

The report also noted the track record from other states, which demonstrates that dental therapy is a safe and effective strategy.

For years, many Floridians — both insured and uninsured — have faced extreme barriers to accessing oral health care. The state performs below average on key indicators. For example, on the national 2017 Child Core Set of Health Quality Measures, Florida is ranked in the bottom quartile for its percentage of children covered by Medicaid who received preventive dental services.

Even more troubling are the number of people who end up in emergency rooms for dental problems. The case of Deamonte Driver is a tragic reference point. This 12-year-old Maryland boy died after bacteria from an abscessed tooth spread to his brain. His family had unsuccessfully searched for a dentist who would accept Medicaid to treat Deamonte’s toothache.

Thousands of Floridians face similar risks. The number of dental-related visits to Florida emergency rooms has grown from 104,642 in 2005 to 163,900 in 2014.

Yes, improvements have been made in recent years, but Florida still has a long way to go. While dentists are stepping up to provide more pro bono services, it’s not enough. Twenty-four counties in Florida have a population-to-dentist ratio greater than 3,000:1. By 2025, the shortage of dental professionals is projected to grow nationwide to 15,600. Dental therapists are another piece of the puzzle to meet the growing needs of Florida’s underserved communities.

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