Dental Therapists: Distraction to a Solution
31% of Michiganders on Medicaid did not see a dentist in 2012. Two years later in 2014, 41% of Michiganders aged 25-34 never saw a dentist that year. Why are so many people not being seen by a dentist? Is it due to the lack of access to the under-served? Are there not enough dentists in certain areas of Michigan? Or is it simply because people do not see their oral health as important?
Senate Bill 541 was introduced to Michigan last year to add a mid-level provider to the dental community in order to approach the needs of the under-served community. This bill was thought to open doors for patients on Medicaid while also providing more dental providers in areas of Michigan that have the largest dental shortage. To become a dental therapist, it would take 2 years at an accredited school and this would allow him or her to practice underneath another dentist’s license. Underneath the dentist’s supervision, the dental therapist would be allow to diagnose, chart, give OHI, take radiographs, perform cleanings, pulp test, give anesthesia, perform primary tooth extractions, and do restorations. While practicing, the dental therapist would be required for half of their patients to be on Medicaid.
It seems at first like this would be a great idea to fix the problem, by adding more dental providers that see the under-served would cause an increase in those that are seen. Although, this is not the root of the problem. Let’s take Minnesota for example, who implemented dental therapists to increase the amount of Medicaid children seen by dentists. Seven years later, the amount of Minnesota’s Medicaid children receiving any dental treatment remained the same as before they implemented dental therapists in the state. The problem is not that there are not enough providers, but that there is a large portion of the population that does not see oral health as a priority today. More and more people lack urgency to go to the dentist and only end up in a dental chair when they are hurting. Education is the most important aspect to helping the undeserved population of Michigan and by showing them how important oral health truly is.
There is no need to make an entire new dental provider to increase dental care in Michigan, and there is a sufficient amount of dentists in the state currently. The main reason why dentists do not take Medicaid is due to the extremely low reimbursement rates. New dentists graduate with an average of 320,000$ in loans. Due to this, new dentists are not as willing to accept insurances with such low reimbursement rates that would barely pay for the cost of the procedure. In addition, a private office would have a hard time employing a dental therapist in Michigan if he or she has to see 50% Medicaid patients and only receives a fee for service reimbursement of 20%. If legislators worked together to increase reimbursement rates for dentists, more dentists would be willing to accept Medicaid in their office and thus increase the access to patients on Medicaid. In addition, continuing to offer loan repayment programs to new dentists willing to go to under-served areas is a great way for students to lower their debt while providing quality care for the people of Michigan.