Updated: Jun 14
Adding midlevel providers will help fill service gaps worsened by the pandemic and economic downturn.
Officials in Michigan are moving to implement the state’s dental therapy law, which was enacted with broad bipartisan support in late 2018. The law authorizes the licensing of dental therapists, who can deliver high-quality care to underserved patients, especially in remote areas of the state. Allowing the use of these midlevel providers will provide supervising dentists the opportunity to focus their time and skills on more complex procedures.
The COVID-19 pandemic and economic slowdown have created new challenges for dental providers, and for patients in need of care. Use of dental therapists in the state will help to ensure that more Michiganders get access to essential oral health services despite these difficulties. According to a recent American Dental Association poll, 22% of dental practices in the United States have either withdrawn or are considering withdrawing from Medicaid by the end of 2020 because of COVID-related obstacles. Given the current situation, Michigan’s efforts to license dental therapists to increase access to care for vulnerable populations are particularly timely.
In September, Pew provided comments to the Michigan Department of Licensing and Regulatory Affairs on the draft rules and expressed support for the proposed licensure, practice requirements, and educational standards for dental therapists. In addition to praising the state’s progress to this point, the letter urges approval of the regulations as drafted.
“Currently, 1.6 million Michigan residents live in areas with dentist shortages,” the letter says. “Limited access to oral health care impacts some of Michigan’s most vulnerable residents, including communities of color, pregnant women, rural residents, and low-income children. In fact, 56% of the state’s children who were on Medicaid—almost 618,000 kids and adolescents—did not see a dentist in 2018. By implementing the Legislation, which requires dental therapists to work in underserved areas, the Rules would help close Michigan’s wide access gap.”
Once finalized, the regulations will create a pathway to licensure for dental therapists. Licensed dental therapists from other states will be eligible to move to Michigan to work, and prospective practitioners will have a clear path toward education, licensure, and employment in the state.
Dental therapists can help dentists respond to financial challenges intensified by the pandemic, in part by making it more cost-effective for practices to participate in Medicaid despite its relatively low reimbursement rates. By taking care of routine and commonly needed preventive and restorative services, such as filling cavities, dental therapists reduce the cost of providing care. Studies show that dental offices that employ these providers can increase the number of patients they treat on Medicaid and still generate profits.
Once the licensure rules are finalized and dental therapists join the Michigan workforce, they will help to increase access to oral health care for underserved communities and make providing for such patients more financially viable for dental practices.
Kristen Mizzi Angelone is a senior manager and Allison Corr is an officer with The Pew Charitable Trusts’ dental campaign.