When can fewer dentists mean better dental care?

The AP reports that, "A judge rejected an effort by the American Dental Association to stop a program allowing dental therapists to provide services in areas of rural Alaska where tooth decay is prevalent.": Judge gives OK to dental therapists (via Juneau Empire, June 29)

The dentists tried to require dental licensing for dental therapists operating in many of Alaska's, small, really rural, and hundreds of miles off the road system remote, villages to meet the full requirements for licensed dentists:

Superior Court Judge Mark Rindner on Wednesday ruled that dental therapists do not need to be licensed by the state. Rindner said that forcing the therapists to get state licenses would frustrate federal goals to reduce tooth decay in rural Alaska.

I assume it would frustrate the goal by mandating a high, but expensive, standard of care, that relatively few could afford.

His ruling means the therapists, who undergo two years of special training and work under a licensed dentist often not on site, can continue operating in villages, said Valerie Davidson of the Alaska Native Tribal Health Consortium.

"The fact our local solution to a local problem is going to make a difference in oral health care delivery for Alaska Natives is really exciting," she said. "It's great to have validation from the court."

The Alaska Dental Society and others tried to stop the program in which at least eight dental therapists are currently doing fillings, simple tooth extractions and other procedures in villages where few dentists operate. The therapists do not perform complex procedures such as root canals, Davidson said.

The dental organizations, plus four individual dentists, sued asserting the therapists require a state dental license.

Attorneys for the tribal health consortium argued the therapists were certified under federal law and didn't need a state license.

The dentists were disappointed:

The immediate past president of the Alaska Dental Society, David Eichler, said his group is disappointed.

"We knew it was an uphill battle to begin with but it was our intention to bring the same high standards of health care to Natives as everyone else in the U.S. has," he said. 

I don't doubt Eichler's sincerity, but this can also be read as an instance of the use of licensing to protect a market niche.  The idea that "one size fits all" (same high standards of health care) also sounds wrong-headed.

Students spend one year in classroom studies at a clinic in Anchorage before taking on clinical work in a rural community. They are required to spend another three months training with a dentist before earning certification as a dental therapist.

The therapist training was offshore outsourced:

The dental therapists working in Alaska were trained in New Zealand.

Comments

[a cosmetic dentist in los angeles]

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-heather-

[Dentist adelaide]

I don't know about this topic more.But By reading your post I got impressed.Now I am interesting to know more about this.

[Dental Lodi]

I feel bad about this news. I understand the feeling of the American Dental Association regarding the program. I also feel for the people in Alaska. If only they can have a common ground to work an agreement to further provide better dental care that isn't too costly.

[r4i sdhc]

Hi,
In 2007, Americans spent $95.2 billion on dental care, or $315 per capita. That represents only 4.3 percent of the $2.2 trillion ($7,421 per capita) spent on health care overall. It's no wonder, then, that dentistry and dental costs tend to be overlooked when policymakers crunch numbers.