Wisconsin has a dental access problem. Federal data report that a staggering 64 of 72 counties face dental shortages, affecting 1.2 million residents. And, while over 1 million residents depend on Medicaid for dental benefits, only 37% of Wisconsin dentists accept Medicaid, many citing low reimbursement rates as the chief concern. This plays a major role in why Wisconsin rates 45th of all states in the portion of Medicaid children who saw a dentist in 2017.
In Wisconsin more than 41,000 emergency room visits for preventable dental conditions were reported by hospitals in 2015, representing nearly $25 million in hospital charges. The connection between oral health and overall health is well documented and advocates agree allowing dental therapists would improve access to care in our state.
A dental therapist is an addition to the dental team – a licensed provider, akin to a physician assistant in medicine, always working under a dentist’s supervision. They are trained to provide about one-quarter of the procedures a dentist can perform, including preparing and filling cavities and doing nonsurgical extractions. Authorizing dental therapists to work with a dentist-led team would increase access to dental care for underserved areas in Wisconsin.
There is no silver bullet to fix dental access in Wisconsin. However, more and more states are joining our neighbors in Minnesota who have allowed dental therapists to practice since 2009 and have documented the success this change has made. In addition to over 50 countries, dental therapists are currently authorized in Michigan, Arizona, Vermont, and Maine, under tribal authorization in Alaska and Washington, and in Oregon via state pilot authority. Several other states are considering legislation.
There are several important aspects of dental therapy that should be understood.
Supervised and Working Collaboratively with a Dentist: Dental therapists work as part of a dentist-led team; they do not practice independently. A dental therapist must be supervised by a dentist under the terms of a written management agreement set by the dentist. Under such agreements, supervising dentists can choose to allow therapists to work under general supervision, providing care when the dentist is not physically present.
CODA Accredited: Dental therapists are well trained and educated. The Commission on Dental Accreditation (CODA), housed within the American Dental Association, adopted standards for dental therapy education in 2015. CODA sets a nationally accepted level of safety and quality for all dental education programs.
A Solution that Works: DTs’ lower wages make it less expensive for practices to treat patients, more feasible for dentists to accept Medicaid, and more attractive for practices to send DTs to underserved areas. A 2014 Minnesota government report found that clinics that hired dental therapists were serving more patients and seeing increased revenue; and more than 80 percent of new patients seen by dental therapists were publicly insured.
Educational Infrastructure in Place: With eight accredited dental hygiene schools in Wisconsin, an infrastructure is in place to train dental therapists. U.S. training programs already exist at the University of Minnesota School of Dentistry, Minnesota’s Normandale Community College/ Metropolitan State University partnership, and Ilisagvik College in Alaska.
For these reasons, our organizations have come together to support dental therapy. We urge you to support legislation this session allowing dental therapy in Wisconsin.
Alliance of Health Insurers • Americans for Prosperity Wisconsin • Anthem • Ascension • Badger Institute • Black Leaders Organizing for Communities • Bread of Healing Clinic • Children's Hospital of Wisconsin • Children’s Health Alliance of Wisconsin • City of Milwaukee • Common Ground Healthcare Cooperative • Community Advocates Delta Dental of Wisconsin • Disability Rights Wisconsin • Disability Service Provider Network • Free and Community Clinic Collaborative • Heartland Institute • Independent Physicians Network • Kids Forward• Milwaukee Latino Health Coalition • National Alliance on Mental Illness Wisconsin • NextDoor • Oneida Nation of Wisconsin • Penfield Children’s Center • Progressive Community Health Centers • Sixteenth Street Community Health Center • Social Development Commission • Southwestern Wisconsin Community Action Program, Inc • SSM Health • The Arc Wisconsin • The Peer Association INC • United Community Center • United Neighborhood Centers of Milwaukee • United Way of Greater Milwaukee & Waukesha County • UW Health • Waukesha County Community Dental Clinic • Wisconsin Assisted Living Association • Wisconsin Association of Free & Charitable Clinics • Wisconsin Association of Health Plans • Wisconsin Association of Local Health Departments & Boards • Wisconsin Association of School Nurses • Wisconsin Board for People with Developmental Disabilities • Wisconsin Community Action Program Association • Wisconsin Community Services, Inc. • Wisconsin Counties Association • Wisconsin Dental Hygienists’ Association • Wisconsin Hospital Association • Wisconsin Manufacturers & Commerce • Wisconsin Oral Health Coalition • Wisconsin Primary Health Care Association • Wisconsin Public Health Association • Wisconsin Rural Schools Alliance
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Dental Health Matters
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