Licensed dental therapists work with dentists much like physician assistants work with doctors. They are licensed by the state, which defines the educational, training and testing requirements needed for a dental therapist license to be granted. Dental therapists have a defined and limited set of practices that they can perform as defined by state law. Midlevel providers can only work under the supervision and direction of a licensed dentist.
Michigan Senate Bill 1013, legislation sponsored by Sen. Mike Shirkey, R-Clarklake, would create a new license for dental therapists and provides the specific requirements for training and practice for these midlevel dental care providers. It requires dental therapists to have graduated from an accredited dental therapy program at a state-approved college or university. These programs are accredited by the Commission on Dental Accreditation. CODA is part of the American Dental Association and provides accreditation for dental education programs. It is the same agency that accredits Michigan’s current dental school programs and dental hygienist programs.
Aspiring dental therapists also have to pass a state test and gain direct experience in dental care before receiving a license to work. The state test would be a comprehensive, competency-based clinical examination to test their knowledge of dental care and the relevant Michigan laws. Completing 500 hours of supervised clinical practice would satisfy the direct experience requirement. To renew a license, a dental therapist would have to complete another 35 hours of state-approved continuing education within two years.
Dental therapists could only work at licensed, state-approved hospitals, local health facilities, federal health centers, health programs operated by a Native American tribe. They could also work at a child health center or other dental clinics whose primarily patients come from low-income backgrounds or do not have dental insurance. Further, dental therapists would only be able to work if they sign a practice agreement with a licensed dentist. This agreement would outline what specific services, among those allowed by the state license, the dental therapist could perform.
SB 1013 would allow dental therapists to perform a number of different services, if approved by a licensed dentist. These include examining a patient’s teeth, taking and analyzing X-rays, cleaning and polishing teeth and filling cavities. Other allowable activities would include fabricating and placing crowns, applying topical preventive agents and sealants, administering local anesthetic and extracting erupted primary teeth. For all other patient needs, a dental therapist would be responsible for referring the patient to the appropriate dental care professional.