BATTLE CREEK, Mich. – As a pioneering program in Alaska attracts attention for bringing sorely needed dental care to underserved communities, the W.K. Kellogg Foundation recently announced that it will support efforts in five states to pursue a similar model, using dental therapists as part of an expanded dental team to end severe dental care shortages across the U.S.
The W.K. Kellogg Foundation will invest more than $16 million by 2014 in the Dental Therapist Project, which includes efforts in Kansas, New Mexico, Ohio, Vermont and Washington, as part of a larger effort to build awareness of oral health access issues and bring quality dental care to every community.
The W.K. Kellogg Foundation, alongside its national lead grantee for the state work – Community Catalyst, is supporting community-led efforts in these states to establish dental therapist programs as a way to expand access to oral health care. Community Catalyst, a national nonprofit advocacy organization that works to build community leadership in the health care arena, will work with states to build coalitions and educate lawmakers on the dental therapist approach.
As a longtime supporter of a range of community-driven solutions for addressing oral health access issues among vulnerable children and families, the Kellogg Foundation believes a multi-pronged approach, which includes prevention, oral health literacy and a strong public health infrastructure, is critical to good oral health. At the same time it is also necessary to increase access to basic, regular dental care for preventing serious problems and identifying and treating problems early when they do occur. Dental therapists, working as part of the dental team, can provide both prevention services and treatment in underserved communities.
Alaska is presently the only state with an active dental therapist program in the United States, as dental therapists have been providing care to Alaska Native communities since 2005. In 2009, Minnesota enacted a law authorizing dental therapists to practice and is now training students in this emerging profession. Other states, including California, Connecticut, New Hampshire and Maine are also exploring this new workforce opportunity as they struggle to address the severe oral health needs in their communities.
In addition, national health reform, with the passage of the Patient Protection and Affordable Care Act, calls for the establishment of pilot programs to test the value of alternative dental care providers – such as dental therapists – to bring oral health care services where they’re needed most.
“It is time now for more states and tribal nations to seriously consider new and proven approaches – such as the dental therapist model – as a way to bring critically needed oral health care services to vulnerable children and families,” said Sterling K. Speirn, president and CEO of the W.K. Kellogg Foundation. “Oral health is essential to overall health, yet good, regular oral health care is out of reach for far too many people in this country.”
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Nearly 50 million Americans live in 4,000 federally-designated areas where there aren’t enough dentists, and millions more can’t afford dental care. As a result, millions of children and adults suffer unnecessarily, miss school or work and, in rare cases, face life-threatening infections from untreated dental decay.
“Too many communities cannot get care because they cannot afford it and there are no providers in their community,” said David Jordan, director of the Dental Access Project at Community Catalyst. “To meet the nation’s unmet oral health needs, we need to extend the reach of dental care to underserved communities by adding new members to the dental team.”
An estimated 10,000 new dental practitioners are needed to end the nation’s dental care shortages, which disproportionately affect low-income communities and communities of color. Yet according to the American Dental Education Association, the number of active dentists in the United States is predicted to decline, indicating that adding more dentists alone cannot solve the dental care crisis.
“We need to bring dental therapists into Ohio,” said David Maywhoor, project director of Ohio’s Dental Access Now! “More than 850,000 Ohioans live in places where there aren’t enough dentists. Traditional responses haven’t been successful in bringing more dentists to the communities where they’re needed most. Dental therapists, as part of an expanded dental team, can help meet the dental care needs of many children and families.”
“New Mexico suffers from severe shortages of dental providers and significant oral health care needs,” said Dr. Gail C. Christopher, vice president of program strategy at the W.K. Kellogg Foundation. “Unfortunately, we know there are tremendous oral health disparities for children of color, and the care provided by dental therapists is culturally sensitive and competent – and can serve as an important addition to the oral health care service delivery system.”
Dental therapists receive two years of intensive training – more than 3,000 hours – to provide preventive oral health care and commonly needed services such as fillings and uncomplicated extractions. They work under the general supervision of an off-site dentist who pre-approves the procedures they perform and reviews their work via phone, fax and Internet. In this way, dental therapists can provide more routine oral health care services while referring more complex services to their supervising dentists – thus extending the reach of the entire dental care team. Other workforce models that require non-dentists to practice under direct supervision of an on-site dentist cannot expand access to care to places that don’t have enough dentists – only the dental therapist working under general supervision does this.
A 2010 evaluation of Alaska’s program found that dental therapists provide safe, competent and appropriate care – reaffirming more than 80 years of research and experience from many countries, including New Zealand, the United Kingdom and Canada, where dental therapists have helped expand oral health care access in underserved communities as part of a comprehensive system of care managed by dentists.
“Americans need affordable dental care where they live,” Speirn said. “It has been 10 years since the Surgeon General’s office issued a report on the deplorable state of oral health in America, calling it a silent epidemic. That silent epidemic is still with us. With dental therapists we have an opportunity to increase access to oral health services.”
Community Catalyst is a national nonprofit advocacy organization dedicated to quality affordable health care for all. Since 1997, Community Catalyst has been working to build the consumer and community leadership required to transform the American health system. With the belief that this transformation will happen when consumers are fully engaged and have an organized voice, Community Catalyst works in partnership with national, state and local consumer organizations, policymakers and foundations, providing leadership and support to change the health care system so it serves everyone – especially vulnerable members of society. For more information, visit www.communitycatalyst.org.
The W.K. Kellogg Foundation supports children, families and communities as they strengthen and create conditions that propel vulnerable children to achieve success as individuals and as contributors to the larger community and society. For more information, visit www.wkkf.org.