Dental therapy in the United States: Are developments at the state level a reason for optimism or a cause for concern?

Safety net patients' satisfaction with oral health services by provider type and intent to return for more care

OBJECTIVES

This study examined patients' satisfaction with services provided by different oral health providers, their intent to return for additional care, and associations with patients' demographics and service characteristics.

METHODS

Descriptive analyses and multivariable ordinal logistic regressions were conducted using survey data from 898 patients who received care at Apple Tree Dental (ATD) in Minnesota during 2021. The questionnaire included 12 statements on patient satisfaction with the clinician's ability to explain the dental diagnosis and treatment options, to be considerate of the patient's needs and dental anxiety, and to provide technically competent services.

RESULTS

In general, patients reported high satisfaction with dental care and a strong intent to return to ATD for future services. No significant differences in patient satisfaction were observed by provider type. Patients' intent to return was higher among non-White respondents (OR = 1.76; 95% CI = 1.06-2.92) and patients who were more satisfied with their providers' technical competence/treatment (OR = 1.47; 95% CI = 1.37-1.57). The association between intent to return and patient satisfaction with providers' information/communication was stronger for patients treated by dental hygienists. The association between intent to return and patient satisfaction with providers' technical competence/treatment was also stronger for patients who were more satisfied with providers' information/communication and understanding/acceptance, and for those treated by their desired or usual provider.

CONCLUSIONS

The study underscores the benefits of introducing dental therapists to the oral healthcare team, showing that this can be achieved without sacrificing either the quality of patient care or patient satisfaction.

Igniting a movement in a dual-licensed dental workforce: The Minnesota model

AIMS

Increased awareness of oral health disparities in the United States has highlighted the need to expand the workforce and access to both primary and preventive dental care. Achieving the goal of oral health equity will require dental team members with appropriate clinical skills dedicated to reaching historically marginalized populations through intra- and interprofessional practice.

MATERIALS AND METHODS

Collective efforts by healthcare advocates in Minnesota led to legislation that created a dental hygiene-based workforce model inspired by the vision and foresight of the American Dental Hygienists' Association's 'Advanced Dental Hygiene Practitioner'.

RESULTS

In July 2023, there were 141 licensed dental therapists and 99 certified advanced dental therapists, the majority dually licensed as dental hygienists/dental therapists, providing primary care services in a variety of settings throughout the state. Current data confirm the contributions of this workforce model to increasing access to primary oral health care for Minnesotans across the lifespan.

CONCLUSIONS

While challenges remain, new opportunities are emerging for dual-licensed dental hygienists/dental therapists to reach intended populations. Minnesota's challenges and successes with the authorization and implementation of a dental hygiene-based workforce model can serve to assist others in developing their own intra- and interprofessional oral health care practitioners.

A survey of dental therapists' practice patterns and training in Minnesota

BACKGROUND

Expansion of the dental team may play a role in increasing access to oral health care. In 2009, Minnesota became the first state to formally license dental therapists (DTs).

METHODS

The authors surveyed DTs and advanced dental therapists (ADTs) in Minnesota to gain a better understanding of those who enter the profession and their motivation for doing so, as well as to solicit their opinions on the overall structure of dental therapy education and the regulatory aspects of the profession.

RESULTS

The response rate was 53.1%. DTs and ADTs were split on whether a dental hygiene degree should be required. Primary reasons for entering dental therapy included more autonomy and a larger scope of practice. Respondents expressed a desire for broadened prescribing rights. The median annual income was in the $81,000 through $90,000 bracket.

CONCLUSIONS

Minnesota DTs and ADTs must practice in underserved communities. However, their ability to expand access to oral health care is affected by their licensure requirement, scope of practice, and prescription rights.

PRACTICAL IMPLICATIONS

Policy makers considering dental therapy legislation must consider educational requirements and scope of practice when crafting state legislation. Broadening the scope of practice may allow for more impactful care for at-risk communities.