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What is Dental Therapy and why is the American Dental Association pushing against it?


Dental therapists are popping up around the country as a potentially cost-effective way to deliver oral care to underserved communities. The American Dental Association is pushing back. Our colleagues over at The Indicator, Wailin Wong and Adrian Ma, explain.

WAILIN WONG, BYLINE: A dental therapist is someone who is trained to do basic exams and cleanings as well as some procedures that are usually reserved for dentists, like filling cavities and pulling teeth.

ADRIAN MA, BYLINE: Beth Mertz is a professor at the University of California, San Francisco, and she researches the health workforce with a focus on dentistry.

BETH MERTZ: They can do a lot of primary care or, you know, do all the basic health care that you need, but they're not a physician.

WONG: In the U.S., a typical dental therapy program takes three academic years.

MA: The first state to introduce dental therapists was Alaska in 2005. Health officials identified a need for basic dental care in tribal communities, especially ones located in rural areas. Today, Alaska has its own three-year dental therapy program through Ilisagvik College, the state's lone tribal college, and most of the graduates are of American Indian or Alaska Native background.

WONG: Kari Ann Kuntzelman is one of those graduates. She's a member of the Chickasaw Nation of Oklahoma. And Kari Ann says having dental therapists in an underserved community can dramatically shorten the wait time for people to get care.

KARI ANN KUNTZELMAN: If you don't have, like, a dentist or a dental therapist that lives in your community - which most of these communities don't have that - they could go a very long time without getting preventative services, let alone, like, emergency type services.

MA: Federal data show that 58 million Americans live in areas with a shortage of dental health providers.

WONG: Poor insurance coverage is another barrier to accessing care. More than 20% of adults and 9% of children have no dental insurance. That's according to the American Dental Association. But the Association also cites data that shows the number of graduates with dental degrees has risen by 8% in the last few years, and that's one reason why they are skeptical about a need for dental therapists.

MA: Jane Grover is a senior director at the ADA, working with the association's Council on Advocacy for Access and Prevention.

JANE GROVER: If you've got this dental workforce that's growing, diverting funds to a new program - a new dental team member is puzzling.

WONG: Now, the ADA does acknowledge the problem of unequal access to dental care, but it's focused on other solutions, like advocating for states to expand Medicaid coverage for adults and encouraging more dentists to accept Medicaid.

MA: Other solution Jane cites is loan repayment programs. These are national and state programs where dental graduates can get help with their student loans. And in exchange, they commit to practicing for a certain period of time in an underserved community or with low-income patients.

WONG: On the federal level, in 2022, an advisory committee issued a report on dental therapy and recommended that Congress make $6 million in annual funding available for dental therapy training programs.

MA: And one of the benefits the committee cited is that dental therapy provides a career path for people in dentistry from underrepresented backgrounds. They can then return to their communities and provide more culturally sensitive care to patients.

WONG: Kari Ann Kuntzelman has experienced this firsthand as a dental therapist who has a native background.

KUNTZELMAN: I'm serving my family. I'm serving my friends. My neighbors are coming to the clinic to see me. It kind of goes back to, you know, when you have a provider that looks like you, that talks like you and has the same background, you're more likely to feel comfortable and to build that trusting relationship.

WONG: Wailin Wong.

MA: Adrian Ma, NPR News.

(SOUNDBITE OF J. COLE SONG, "FORBIDDEN FRUIT") Transcript provided by NPR, Copyright NPR.

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Adrian Ma
[Copyright 2024 NPR]
Wailin Wong
Wailin Wong is a long-time business and economics journalist who's reported from a Chilean mountaintop, an embalming fluid factory and lots of places in between. She is a host of The Indicator from Planet Money. Previously, she launched and co-hosted two branded podcasts for a software company and covered tech and startups for the Chicago Tribune. Wailin started her career as a correspondent for Dow Jones Newswires in Buenos Aires. In her spare time, she plays violin in one of the oldest community orchestras in the U.S.