National Efforts to Enact Dental Workforce Reform

Although only three states have approved dental midlevel providers, along with several Native American tribal communities in Alaska, Washington and Oregon, the idea is gaining momentum nationwide, and often drawing bipartisan support. In 2015, a bill authorizing dental hygiene practitioners (the equivalent of dental therapists) was introduced in Texas by Democratic lawmakers. A diverse coalition of groups endorsed it, including the Texas Hospital Association, the right-leaning Americans for Tax Reform, and the left-leaning Center for Public Policy Priorities.[59] Although the bill failed to pass, a poll of likely voters statewide found that 89 percent supported the idea. Support was strong among Democrats (90 percent), Republicans (90 percent), and independents (87 percent).[60]

A more recent poll conducted by Wilson Perkins Allen Opinion Research for Americans for Tax Reform found similar support across the United States. Of likely voters, 79 percent expressed support for creating a dental therapist license, while only 15 percent opposed this idea. Among partisan groups, 77 percent of Republicans support dental therapists, as did 80 percent of Democrats and 80 percent of independents.[61]

In Massachusetts, where more than half the low-income adults and children received no dental care of any kind in 2014, a bill creating dental hygiene practitioners failed in the Joint Committee on Health Care Financing. It was, though, subsequently passed unanimously by the Senate.[62] In Ohio, a dental therapist bill has been introduced in the Senate, and New Mexico’s House of Representatives passed a bill last year that would have created midlevel dental providers, but it failed to pass in the Senate.[63]

Bolstering these legislative efforts, the Commission on Dental Accreditation voted in August 2015 to implement dental therapy education standards after three years of research and evaluation of the efficacy and safety of the midlevel provider model.[64] CODA is an independent entity recognized as the national accrediting agency for dental education programs by the U.S. Department of Education, so its recognition of professional education standards for dental therapy is significant.

Moreover, the CODA decision was endorsed by the Federal Trade Commission, which had previously urged the adoption and implementation of standards “which would facilitate the mobility of dental therapists from state to state to meet consumer demand for dental services.”[65]