Dental Care concerns: Quality or quantity?
When it comes to medical service, seeing the best possible provider is always the goal. But sometimes lower quality medical service is better than no service at all. In a large city with multiple hospitals and clinics, I can be picky about which doctors and dentists I want to see. I know people that stopped seeing a particular dentist because they didn’t like the way their office assistant answered the phone. That’s the type of result you get when you have multiple dentists at your service. On the flip side of that you have places in the United States where medical treatment is scarce. In places like this, you probably won’t find someone refusing a dentist’s service because of phone etiquette. In fact, in places like that you might not be able to refuse service from a dentist at all, because there are no dentists to refuse service from. It’s in desolate places like this where the service of dental therapists could be extremely valuable. Desolate places like the prairies of North Dakota.
The idea of dental therapists (mid-level oral health practitioners supervised by DDS) can be controversial. Dental therapists make us ask the question “is lower quality dental work better than no dental work at all?” North Dakota’s state legislators have been asking themselves this question as they contemplate ND HB1426. This bill, if passed, would amend sections to North Dakota’s century code to allow for a new category of dental care called dental therapist. Factoring into the minds of North Dakota legislators is the concept that adding more dental care providers should, in theory, provide more service to the citizens of North Dakota, especially those in underserved areas of the state. This added quantity of service would likely come at a cost though. These new providers will have less training than traditional dentists. Therefore, asking the age-old question “quantity or quality?” With similar bills being introduced and failed in 2015 and 2017, it seems that state legislators have answered repeatedly with quality over quantity.
North Dakota isn’t the first state to introduce the idea of a dental therapist. Currently, there are six states that allow forms of dental therapists. In Alaska, Washington, and Oregon dental therapists are limited to practicing on authorized Native American tribal land. Maine, Vermont, and Minnesota allow the practice throughout the state.
The fact that this bill is being introduced for a 3 time in 4 years seems to drive home the idea that there are people in North Dakota in need of dental services. It’s obvious that more providers could see more patients. But are bills like HB1426 discriminatory and possibly dangerous for people’s health? The goal of the dental therapist is to serve those in underserved communities. By not seeing a license DDS, does this bill put those underserved patients that are in need even further away from getting the quality treatment they deserve or need? As dentists, what do you think: do dental therapists help or hurt the dental healthcare industry?