A December 2014 report by the California state auditor found that more than half of the children enrolled in that state’s program for low-income children (Denti-Cal) were not getting regular dental care. It also found that 32 of California’s 58 counties have dental access problems because of a shortage of dentists.
On the other side of the country, the Vermont Department of Health recently estimated that low-income children in that state are more than twice as likely to experience untreated tooth decay. As a consequence, many of them wind up in hospital emergency rooms—the most expensive place to get care—when the pain becomes unbearable. The state’s Medicaid program reported spending $2.5 million of taxpayers’ dollars annually to treat emergency tooth decay problems for children under the age of 6.
As in California, Vermont officials and healthcare providers say there simply are not enough dentists to meet the need, or at least not enough who are willing to see Medicaid patients.
“I can tell you that access to oral health care is the single largest problem facing our patients,” Peter Youngbaer, director of the People’s Health and Wellness Clinic in Barre, told Vermont Public Radio in February dental lab supplies australia. He said that 44 percent of the patients who visited the clinic in 2014 had not seen a dentist in at least five years. Many of them said they had never seen a dentist.
To alleviate the problem, several patient and consumer advocacy groups are hoping Vermont will follow Maine’s lead in permitting mid-level dental providers to practice in the state dental curing light. Maine last year became the third state in which mid-level dental therapists can practice. Alaska and Minnesota are the other two so far.
The Vermont Technical College plans to offer a program to train dental therapists, who would work under the general supervision of a dentist and provide a limited scope of services, ranging from preventive care to simple extractions and fillings.
Beth Nolan of Voices for Vermont’s Children told Vermont Public Radio that her organization supports expanding the dental workforce because efforts to recruit more dentists to treat low-income patients have not been successful dental vacuum forming machine.
“Without an alternative workforce model for dentistry, low-income patients will continue to be denied access to care,” she said.
Satcher agrees. He has joined a growing number of healthcare professionals advocating for expanding the dental workforce throughout the United States.
“States should explore all options that could expand access to care,” he wrote in a commentary, “including allowing midlevel dental providers such as dental therapists to practice.”