The current pandemic that we have been struggling against has not only created issues for dentists such as a myriad of  COVID-19 protocols, PPE changes and skyrocketing costs related to it, and a decrease in production but has exposed underlying issues with our healthcare system. In particular, inadequate access to oral care has made an oral crisis even more acute. 

 

While many ideas to improve access to oral care are very promising, many proposed bills are promoted by politicians with no understanding of how health care works. The proposed legislation can be questionable and can actually do the opposite of what it was intended to do. 

 

EXPANDING ACCESS TO ORAL CARE

A recent survey by the Pew Foundation found that over 300,000 Americans will get dental coverage through Medicaid. Unfortunately, due to the historically low reimbursement rates for Medicaid, there are shortages of Medicaid providers, especially in urban areas. Without either (or both) an increase in reimbursement rates or a reduction in the wages of dental staff, there will continually be a problem with providing oral care to all Americans.

 

Several states have attempted to address this issue with the expansion of dental therapists. A dental therapist can provide routine and minor restorative care under the supervision of a licensed dentist. The scope of practice varies from state to state (a handful of states allow dental therapists now).

 

FLORIDA SB 604 

Most recently, a state senator from Florida proposed legislation that would expand the role of a dental therapist. Under SB 604, dental therapists, under the supervision of a dentist, would be able to perform preventative and simple restorative procedures. The basis for this is by increasing the number of dental providers in Florida, access to oral care is increased while reducing the cost of dentistry. I am sure we are all supportive of any measure to improve the oral care of Americans but it should be done methodically to ensure proper care is rendered at all times.

 

This bill is in line with other states that are considering or have already expanded the duties of dental auxiliary staff. Such proposals can increase access to care (if properly set up) but it can also result in questionable dentistry being performed. Dentistry is not just “drill and fill” but is a part of the overall health of an individual. What occurs in the oral cavity affects other organ systems. A holistic view of dentistry as part of the entire health must be taken. 

 

MAKE YOUR VOICE HEARD

Now more than ever, it is important for dentists to stay informed of all the fast-moving laws being introduced. This can mean being active with organized dentistry or even active on social media groups like Nifty Thrifty. Let’s learn from each other. We all have our own unique experiences and perspective that can benefit others. Let’s collaborate to improve oral care in our country!

 

If we do not play a large part in creating a solution then we have no right to complain when we don’t like the results pushed on us by politicians. Dentists have the knowledge and it is important for us to contribute to any proposals put forth by our government officials. 

 

It is hard to hear a single voice but united, it is hard to ignore a roar!

 

References:

https://www.pewtrusts.org/en/research-and-analysis/articles/2019/01/15/efforts-to-expand-access-to-oral-health-care-to-continue-in-2019