US report suggests Dental Therapist model economically unsustainable

The idea that an alternative dental care model may work in places where there is a shortage of dentists has been challenged by the American Dental Association.

A series of reports commissioned by the American Dental Association (ADA) to examine alternative dental workforce models has raised questions as to whether those models are economically sustainable. This follows suggestions in the US that scope of practice for dental therapists be altered to solve workforce shortages in some US states.

Performed by ECG Management Consultants, an agency with extensive experience in research and policy issues, the studies modelled 45 different scenarios based on a comparison between estimated revenues and estimated expenses for each of the three providers under three payer mixes. ECG produced separate reports for the five states where adopting one or more of these models has been under discussion in the legislature or the public health community.

“These studies represent a new way of examining whether alternative workforce models are an economically viable way to improve access to dental care for underserved populations,” said American Dental Association President William R. Calnon in a report on the Association’s website.

“The studies are a first step, and not the last word.  But certainly, lawmakers and public health authorities should consider the factors examined in the studies carefully before rushing to create dental providers that may be unable to fulfill their intended purpose of reducing oral health disparities,” he said.

He was keen to describe the studies as a starting point for more discussion. “It is critical to understand that oral health disparities are a complex set of problems requiring an integrated set of solutions,” he said. “Medicaid reforms, community water fluoridation, oral health education and helping people overcome cultural, geographic and language barriers are critical components of this. The ADA believes that allowing nondentists to perform irreversible surgical procedures is the wrong way to go. And based on these studies, midlevel dental providers would in most settings be unable to generate sufficient revenue to sustain themselves absent a continual source of financial underwriting. Given the current budget constraints at every level of government, and the already insufficient financing for dental care in most states, these three workforce models do not appear to be viable.”

The reports findings are in contrast to findings of studies like this one, which suggested expanding scope of practice for therapists would help solve problems of access to dental care for rural and regional Alaskans.


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