Dental Health Professional Shortage Areas as of October 7, 2011. From the Kansas Department of Health and Environment Bureau of Local and Rural Health.
It’s a nagging problem for rural areas: not enough dentists to provide adequate care for the population.
In Kansas and a few other states, advocates and some lawmakers want to solve this problem by creating a new level of dental care. A registered dental practitioner, or RDP, would have more training than a dental hygienist, but less than a dentist. Midlevel dental providers have been practicing in Alaska since 2005, and legislation recently passed in Minnesota to establish the new level of care. Bills have been introduced in Ohio, New Mexico, Vermont and Washington.
In Kansas, bills were introduced in the state House and Senate during the 2011 legislative session and await further action next year. And now Fort Hays State University is offering to start training these midlevel dental providers — if and when state lawmakers give the idea the green light.
“Two of the main things that an RDP will be able to do is extractions of … teeth and basic restoration, so drill and fill,” said Cathy Harding, who heads the Kansas Association for the Medically Underserved. Harding says these providers can help address a shortage of dentists — especially in rural Kansas — that is severe and growing.
The new providers would operate much the way nurse practitioners and physician’s assistants do in medical clinics. RDPs would be required to work under the supervision of a licensed dentist. Harding says she’s thrilled that Fort Hays State has agreed to offer a four-year bachelor’s degree program for registered dental practitioners, pending approval by the Legislature and the Board of Regents.
But while Fort Hays State’s interest shows some momentum building for the proposal, the idea has formidable foes. The Kansas Dental Association opposes it, and the American Dental Association has expressed serious concerns about the concept. At a recent legislative hearing, two pediatric dentists testified that the RDPs would not have adequate training for procedures such as extracting teeth and filling cavities. They argue that this would mean a two-tiered system of care in Kansas — top-quality care for those with the money to pay for dental services and lower-quality care for those who can’t pay.
That is not the opinion of all Kansas dentists, however. Melinda Miner, who practices general dentistry in Hays, one of the larger communities in western Kansas, notes that the new providers would be under the direct supervision of a dentist. She says that dentist would be accountable for ensuring that the dental care provided by the RDP meets the appropriate standard of care. Miner says she visited Alaska this summer and was impressed by the quality of care provided through a similar program there.
Miner says she was “saddened” that the Kansas Dental Association opposed this new concept without first discussing it with its members.
Related coverage: Kansas’ Oral Health Care Provider Shortage
→ Bill considered that would allow dentists to have more practice locations (2/18/14)
→ Statehouse push made for mid-level dental practitioners (2/12/14)
→ Americans for Prosperity joins effort to license mid-level dental providers (1/8/14)
→ Kansas Medicaid program still lags nation in oral health care for kids (11/12/13)
→ Kansas dental program for children on hold because of KanCare MCO (11/11/13)
→ Dental mediation effort ends without compromise (11/4/13)
→ Disputing parties enter formal mediation over mid-level dental providers (10/3/13)
→ Pew report cites need for mid-level dental providers (6/25/13)
→ Dentist groups announce scholarships for dentists going to rural areas (2/7/13)
→ Advocates for mid-level dental providers meet with legislators (2/6/13)
→ Bill to license mid-level dental providers introduced (1/29/13)
→ Regents will hear proposal to train mid-level dental practitioners (10/17/12)
→ Dentist shortage proposal not funded in Regents’ recommended budget (9/20/12)
→ Report questions economic viability of mid-level dental providers (7/26/12)
→ Task force recommends building state’s first dental school (6/21/12)
→ Dentists shouldn’t fear mid-level dental care, expert says (4/20/12)
→ No consensus on how to end ‘dental deserts’ (4/9/12)
→ Worldwide review says mid-level dental providers give good care (4/10/12)
→ Bill to increase dental care access given initial approval in Senate (3/15/12)
→ New caucus told of oral health success in southeast Kansas (3/8/12)
→ More Kansans head to ER for dental care (2/29/12)
→ Dental association says new program will increase access in rural areas (2/2/12)
→ ‘Turf battle’ continues over dental practitioner bill (1/30/12)
→ Summit to focus on training plan for mid-level dental practitioners (11/29/11)
→ Between a hygienist and a dentist, a hard sell (10/26/11)
→ Political fight continues over mid-level dental practitioners (10/11/11)
→ Better prevention would help solve dentist shortage, advocate says (7/22/11)
→ Dentists: Practitioner bill flawed (3/9/11)
→ Videos detail shortage of Kansas dental providers (12/8/10)
→ Slow going in efforts to solve state’s dentist shortage (8/30/10)
→ Safety-net clinics filling gap in dental services to low-income Kansans (8/30/10)
→ Replacing town’s only dentist ‘hardest’ project ever (8/30/10)
→ Progress made on oral health, but problems remain (1/14/09)
→ Funding bill contains seed money for ‘dental hubs’ (5/4/07)
→ Increasing access aim of oral health coalition (12/21/06)