by Lory Laughter, RDH, BS
I remember the days when Google was not a common or understood word. Admitting to my mother that I was Googling something would have caused her even more worry about my future as a daydreamer. (Or a reply of, "You really shouldn't do that.") No longer do we tell children to look in the dictionary or encyclopedia when a query arises – we instruct them to "Google it." Today, when my mind dwelled on the question of what is happening to our profession, Google was what I turned to in a search for answers.
During my Google session, I happened across a site called The Lund Report at www.thelundreport.org. The site brags about "unlocking our health care system," and its mission is to shine a light on the Oregon health care industry to help create a more accountable and transparent system. There are articles on reform, insurance, and even Weight Watchers for school employees, but the story that caught my eye dealt with a compromise between dental care groups regarding legislation to create the dental therapist position. This is not a new topic, but it doesn't generate a lot of discussion among the dental communities I've visited online.
Senate Bill 227 is backed by those who point to the success of Alaska's dental therapists, as well as a similar program in Minnesota. While this bill will not create a new level of provider, it will expand the scope of existing health-care providers known as limited-access permit hygienists. I like the inclusion of the word "hygienist." Their new title will become expanded practice dental hygienist to reflect their expanded role in providing care.
From my brief review of the bill, it appears the compromise made by the dental health groups will allow the hygienists to serve populations that now have no care. I recommend every RDH in every state read the bill, decide what sections to support in their state, and start the push. There is no reason that underserved populations need to continue to suffer due to egos and lack of compromise on all sides.
Oregon is not the first state to pass this type of legislation. That distinction belongs to Alaska according to the Alaska Native Tribal Health Consortium at http://www.anthc.org/chs/chap/dhs/index.cfm. The Alaska program welcomes applications from high school graduates and makes no mention of previous dental experience. Alaska dental health care therapists join existing dental teams to provide routine restorative care and be active ambassadors of oral health in their communities. Therapists serve in the communities where they live.
The University of Minnesota offers two tracks for meeting the requirements to become a dental therapist – a bachelor's and a master's program. I like that the education is received in a university setting alongside dental and dental hygiene students. It does concern me a bit that no previous dental experience is required. The Minnesota program does not limit a dental therapist to employment in underserved areas, according to the school's Web site. A year of college prerequisites is required to enter the bachelor's program. More information on how the Minnesota dental therapist legislation came into being can be found on the ADHA Web site at http://www.adha.org/downloads/MN_Mid-Level_History_and_Timeline.pdf.
California has RDHs in alternative practice to help meet the needs of the underserved and those who cannot access traditional office care. A few other states have some type of nontraditional provider to help meet the oral health needs of their populations.
As health-care providers, I believe all RDHs have a commitment to community service. We need to use our search engines to find out what programs exist and how we can influence the midlevel provider created in our area. Someday midlevel dental providers will be common rather than a cause for argument or debate – it is up to us to be instrumental in assuring our role and survival in that capacity. Google it for yourself and make a plan – your mother will understand.
Lory Laughter, RDH, BS, practices clinically in Napa, Calif. She is the owner of Dental IQ, a business responsible for the Annual Napa Dental Experience. Lory combines her love for travel with speaking nationally on a variety of topics.
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