In one of the most memorable scenes in Cast Away, Tom Hanks, who is stranded on a deserted island and has a toothache, gruesomely removes his tooth with a figure skate because he can no longer live with the pain.
Even though they are not stranded on a deserted island, more than 80 million Americans suffer in pain because they cannot access regular dental care. While unserved and underserved Americans may not rely on a figure skate to deal with their untreated oral health pain, they are forced to take drastic measures due to dentist shortages and lack of affordable dental care.
Congressman Elijah Cummings (D-MD) regularly describes how his family dealt with untreated dental disease and pain — with a toothpick, turpentine, cotton balls and Orajel. Congressman Cummings reminds us these tools are not uncommon, but rather the norm, in medicine cabinets throughout the country.
Fortunately, we can all agree figure skates, toothpicks, turpentine, cotton balls and Orajel are not the solution to our nation’s unmet oral health needs. We need to work together to extend dental care to the 49 million Americans who live in dental professional shortage areas and communities without enough dentists to serve them.
One promising solution to our severe dental professional shortage is to expand the reach of dental professionals into underserved communities by adding dental therapists to the dental team. Internationally, dental therapists have helped extend the reach of dental professionals into underserved and rural communities for more than 90 years.
Dental therapists are well established professionals who work as part of the dental team. 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 offsite dentist who preapproves the procedures they perform and reviews their work via phone, fax, and the 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.
Community Catalyst, with generous support from the W.K. Kellogg Foundation, has partnered with advocacy organizations to launch campaigns in five states — Kansas, New Mexico, Ohio, Vermont, and Washington. The campaigns will build awareness of how dental therapists can meet unmet oral health needs and educate policymakers about how the addition of dental therapists can extend the reach of the dental team into underserved communities. Our partners will work at the state level to engage consumers, policymakers, dental professionals and stakeholders in discussions on improving oral health care delivery.
Historically, countries looking to increase access to care have looked to dental therapists. Most recently, Alaska Natives looked to dental therapists as a solution to dentist shortages and lack of affordable dental care. In fact, dental therapists have provided quality dental care to Alaska Natives since 2006. Recently, an independent evaluation conducted by RTI International found dental therapists in Alaska provide safe, competent and appropriate care. This study reaffirms multiple studies’ findings on dental therapists and over 90 years of experience that dental therapists provide quality, affordable dental care.
As we struggle to meet our nation’s unmet oral health needs and look for solutions to bolster our health care workforce, dental therapists offer a tangible and proven way to deliver affordable care.
Congressman Cummings also likes to remind his audience that “People don’t know what people don’t know.” The Dental Therapist Project enables us to inform consumers about how important their oral health is to their overall health. Our work will help consumers understand that quality affordable dental care is not a privilege but a right. After this Project, they’ll know their voice is the most important voice in shaping how their dental care is provided.
As we implement health reform, the Dental Therapist Project allows us to let policymakers know that too many Americans live without dental care because of a shortage of nearly 10,000 dentists. They’ll know how important alternative providers are to ensuring dental care can be available to their constituents who live in the 4,000 dental professional shortage areas. They’ll also see the facts overwhelmingly show dental therapists provide high quality, safe care and 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 adds the opportunity for patients to get care in communities without a professional to treat them.
We will also work to let dentists know that millions of Americans face barriers to getting dental care. We will work with dentists so they understand that every day millions of Americans live without dental care because they can not afford it or because a dentist is not available in their community. We will help them understand that driving hours to see a dentist should not be acceptable. Most importantly, we will work with dentists to show that dental therapists, as part of a dentists led dental team, can extend the reach of the dental team into underserved communities.
Our work is clear, we need to help people know what they don’t know about oral health — that it is important and should not be out of reach for anyone in any community. We will work to expand care to every community by engaging the community in how to best to deliver quality, affordable care. For too long, many communities have faced both financial and geographic barriers to dental care. Their voices have not been heard in the oral health policy debate, almost as if they were on a deserted island. The Dental Therapist Project will add the community’s voice to the oral health policy discussion.
– David Jordan, Director, Dental Access Project