by Christine Nathe, RDH, MS
In recent years, many proposed new and alternative dental providers have surfaced, and all have a specific scope of practice and corresponding educational preparation. Most recently, grants have become available through the federal government that include demonstration projects to establish programs to train or employ alternative dental health providers.
The main objective of these new provider models is to increase access to dental care in underserved communities. When we create new provider models, it is important that we ensure optimal standards of care and safety to the public, while also ensuring that the new provider has corresponding rights and responsibilities.
These dental providers need to have the same educational preparation in theory and practice that dentists and/or dental hygienists have, depending on their respective proposed scope of practice. We all want providers who are confident in their ability to understand and practice the dental sciences. We need to make sure we’re protecting the public we serve.
It is also important that we think in advance how to best create providers who are educationally prepared, including a commensurate degree. We want to make sure their competence is reflected in the same manner as it is with existing providers, such as in a college degree and state licensure. We also need to make sure that we are protecting these new providers.
It may be argued that it is difficult to educate these providers within their communities, but most have the desire to stay in their communities and still have a college degree awarded.
We can try to involve institutions of higher education and also keep them in their communities. We should do both — we should educate providers indigenous to their communities so that the health providers are a reflection of their communities, and involve reputable educational institutions.
We need to ensure that these new providers do not “do the time” without reaping any of the benefits that a college degree affords, just because they are from a certain community and we are trying to help them stay within this community. This could be seen as trying to create providers that do not have the prestige afforded to dentists or dental hygienists who possess college degrees. We do not want to create any dental providers that could be seen as indentured servants. If we propose that new providers attain the skills of dentists and dental hygienists, then they need the same training, and with that training commensurate degrees should be reflected.
Americans value education and college degrees. We need to be proposing new providers who are entrusted with dental hygiene skills (such as community dental health coordinators), restorative dental skills (such expanded function dental providers) and emergency and restorative dental skills (such as dental therapists) and we need to award them a college degree, since they should be completing college level courses. Let us not repeat the mistakes of history just because we want a quick fix. We need to develop ideas that protect the public, and we must also protect the rights of these proposed health care providers!
Christine Nathe, RDH, MS, is a professor and graduate program director at the University of New Mexico, Division of Dental Hygiene, in Albuquerque, N.M. She is also the author of “Dental Public Health” (www.prenhall.com/nathe), which is in its second edition with Prentice Hall. She can be reached at [email protected] or (505) 272-8147.
A key provision in the final health reform bill targets dental health providers. Grants will be awarded to programs that will train or employ dental health providers in underserved communities. Advanced practice dental hygienists, public health dental hygienists, independent dental hygienists are among those eligible for the grants.