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Michigan Senate Approves Bill To Authorize And License Dental Therapists

Only half of all U.S. adults say they visit their dentist every six months, and that means there are far too many Americans who aren’t following recommended guidelines for oral health. Whether it’s due to high costs or lack of convenience, it’s a problem that Michigan lawmakers have sunk their teeth into. The state Senate has now passed a bill that will make dental care more accessible to patients by authorizing and licensing “dental therapists” to perform many of the same duties currently handled by dentists.

The legislation, which won Senate approval 25 to 15 in early October, would essentially create a new, mid-level dental professional position known as a dental therapist. These therapists would be able to practice the basic dental care functions (like including simple teeth extractions and dental fillings) for which dentists are currently responsible. The bill includes the training and educational requirements that would have to be met before they could become licensed and also lays out in detail the sort of agreement the therapist would be required to have with a supervising dentist in order to practice.

Proponents believe that this new position could help close the care gap that exists in many rural and underserved areas of Michigan. Amy Zaagman, executive director of the Michigan Council for Maternal and Child Health, explained to Michigan Radio that dental therapists would be able to practice only in areas that have dental shortages or in safety net settings. They may also practice in facilities wherein at least half of their patients meet certain low-income requirements.

Still, not everyone is in favor of the bill. The Michigan Dental Association is strongly opposed to the legislation. Their stance is that the problem lies not in a shortage of qualified dentists but in low Medicaid reimbursement rates.

Bill Sullivan, the vice president of government affairs for the MDA, told Michigan Radio, “If the reimbursement rate could be increased, the dentists are there to provide the care. They’re there to provide the care if they will at least not lose money every time they see a patient.”

Others point out that even if there are enough dentists to feasibly go around, the fact that there are few affordable options available to low-income residents would essentially have the same effect: neglected dental care. And in an opinion piece published in the Oakland Press, columnist Michael Van Beek points out that without affordable preventative care, a lot of residents have to either endure their pain or go to the emergency room — an even more colossal expense. In fact, a 2014 study found that 7,000 Michigan patients went to the ER in 2011 for symptoms that resulted from preventable dental issues. The costs of hospital visits can be astronomical: in 2013, the average cost of just one day spent in a U.S. hospital was $4,293, and even just a night in the ER can cost upwards of $1,000 in some cases. These oral problems can also result in missed school or work and a poorer quality of life. In addition, an increase in untreated dental issues can actually drive up prices throughout the health care market in general, making it even harder for those in underserved populations to access the care they need.

Currently, 77 of Michigan’s 83 counties contain at least one area deemed as having a dental shortage, which translates to millions of local residents who do not have regular access to this type of care. The House Health Policy Committee will vote on the bill, known as S.B. 541, next. If passed, Michigan will join the ranks of Minnesota, Maine, and Vermont, which have already authorized and licensed dental therapists throughout their states.

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