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Once Is Chance, Twice is Coincidence, Third Time Is a Trend

This post was originally posted on the Health Policy Hub Blog.

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Rowena Ventura, director of We Are the Uninsured in Cleveland, knows firsthand the horrific effects that the lack of affordable dental care can have. She tells of how a woman she knew died on the streets after losing her job because she was unable to see a dentist and of how her own son, a roofer, wound up pulling his own tooth and losing three more after he got an infection.

Every day, millions of Americans, like those in Rowena’s life, suffer and struggle because they can’t get dental care. In 2010, 181 million children and adults went without any dental care at all.

With glaring gaps in the delivery system preventing people from getting affordable care in their community, policymakers, researchers and the media are increasingly focusing on the use of dental therapists – an evidence-based solution that can address this crisis, one that expands the ability of the dental team to treat underserved populations. In the last few weeks, we have seen a trend of independent research and support from policymakers and dentists emerge.

First, Senators Max Baucus and Charles Grassley issued a Joint Staff Report in which they note that access to dental services is a concern and empowering mid-level providers is a common-sense solution.

Dr. Richard Katz, a California dentist and business owner, raised mid-level dental providers again, in an op-ed published Aug. 6 in the Huffington Post, where he asserted that mid-levels known as dental therapists “can improve the lack of access to many Americans, as one in seven live in an area where there is very little availability. These mid-level practitioners would be able to serve more people at a lower cost.”

And, on Aug. 9, the Washington Post’s Wonkblog carried a piece by Harold Pollack that shed light on the severe problems in our dental delivery and financing system. Some 85 million Americans lack dental insurance; Pollack notes that while raising Medicaid rates for dental services is important, money alone won’t solve this problem. One important way to bring dental care to Medicaid patients, he says, is to “expand services provided by mid-level providers known as dental therapists.” Which, as a recent report released by Community Catalyst demonstrates, is exactly what dental therapists in Minnesota and Alaska are doing: increasing the capacity of safety-net providers to treat underserved populations in their communities.

Taken together, these articles and studies bring to mind the old saying, “Once is chance, twice is coincidence, third time is a trend.” Dental therapists are catching on.

Someday, the practice of dental therapists in the United States will be the norm – in much the same way that the practice of medical mid-levels such as nurse and physician practitioners is the norm today. Demographic realities and market changes will continue drive this trend. The tipping point for dental therapists will happen sooner rather than later because from a cost and access perspective, we simply can’t afford to wait.

Stay tuned for part II of this post, which will detail how dental costs are driving this issue.

- David Jordan, Dental Access Project Director, Community Catalyst

Word of Mouth