Mid-level dental providers: Innovation Washington Needs


It’s not often that you get a chance to see the future. Recently, however, we were invited on an educational trip to Alaska, where we saw the future of dental practice.

There, mid-level dental providers known as dental therapists are extending high-quality preventive and routine care to tens of thousands of people who otherwise wouldn’t have access.

We came home convinced this innovation is needed in Washington, where an overburdened dental care system is failing too many people who can’t get the dental care they need.

In Washington, dental related problems are the number one reason uninsured people seek care in emergency rooms and it is a leading reason for people on Medicaid. This can be prevented when people have access to everyday dental care.

Mid-level dental providers in the U.S. receive high quality education that is focused on prevention, education and early intervention. They are also trained to stop the disease from spreading, undergoing an intensive two-year education program to become proficient at providing a defined set of commonly needed services, including non-surgical extractions and fillings.

They use the same textbooks that dental school students use to learn the procedures. By the time they are ready to practice, dental therapists have as many hours of field experience in the procedures they are certified to perform as a dental school graduate has.

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Mid-level providers offer first-rate care—they truly are experts at what they do.

We know because we saw them treat patients. Dental therapists work as part of a dentist-led team and utilize off-site supervision to extend routine dental care to places care is needed most. They communicate with their supervisor regularly and are trained to quickly recognize when a situation needs referral or consultation with their supervising dentist.

This arrangement allows the dental team to provide good care to more patients – expanding access while ensuring quality. And, by focusing their practice on a narrow set of routine procedures, they free up dentists to provide more complex care.

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Now also practicing in Minnesota, mid-level dental providers such as dental therapists strengthen and modernize the dental care system in accordance with the needs of communities.

In Washington dentists and clinic leaders will determine how best to incorporate these new team members into their practice – for example, by extending clinic hours and seeing patients on weekends, using mobile vans or sending mid-levels into community settings such as schools or nursing homes.

Currently, Washington is among 20 states actively exploring this common-sense approach to expanding oral health care access, but now it’s time to act. Let’s bring dental therapists – and the future of dental practice – here to Washington.

ALEX NARVAEZ, DDS, is dental director of Sea Mar Community Health Centers, which sees more than 54,000 patients annually in nine counties across western Washington. JOHN STEPHENS is a Board Trustee with Skagit Valley College and Programs Administrator of the Swinomish Indian Tribal Community. Both are active in the Washington Dental Access Campaign, which supports a workforce solution that meets the needs of our most vulnerable populations. To learn more about the Campaign, click here.