Despite COVID-19 Challenges Dental Therapy Had a Watershed 2020 and Is Poised to Grow

2020 was a difficult year for dental providers as the COVID-19 pandemic swept across the country. When stay-at-home orders went into effect in the spring, dental offices closed their doors to all but emergency patients. And, as a result of pandemic-related financial constraints, 22% of dental practices that participated in Medicaid either withdrew or considered withdrawing from the insurance program by the end of the year, according to the American Dental Association.

Despite these once-in-a-lifetime challenges, however, the field of dental therapy made important strides last year that lay the foundation for continued progress in 2021. Dental therapists are midlevel providers, similar to physician assistants in medicine, whom dentists hire to extend quality care to more patients, expand their practices, and deliver treatment to underserved populations. Here are some of the highlights of 2020:

First dental therapy education program gained accreditation

In August, dental therapy education reached a critical milestone when Iļisaġvik College in Alaska became the first dental therapy training program in the United States to receive accreditation from the Commission on Dental Accreditation (CODA), the same oversight board that accredits schools for dentists and dental hygienists. This approval is a recognition of the high-quality education and effective training that Iļisaġvik College offers.

“The achievement of CODA accreditation lends credibility on a national scale and opens the way for other programs to follow our lead,” said Dr. Mary Williard, a dentist who chairs the college’s dental therapy program. “We are now an important step closer to the day when dental care is no longer a privilege but is available when and where it is needed.”

Other U.S. colleges and universities are working to follow Iļisaġvik College in developing and launching accredited dental therapy training programs. Notably, Vermont Technical College’s program expects to submit its application for accreditation in early 2021 and admit its first class of students in the fall of 2022. The college, which will offer the first dental therapy training program in the Northeast, is finalizing partnerships with community health centers that provide primary medical and dental care in underserved areas of Vermont and Maine to help train the region’s dental therapists.

Dental therapy advanced in Maine and Michigan

In October, New England’s first dental therapist was hired in Maine. Claire Roesler received an M.S. in dental therapy from the University of Minnesota and joined Penobscot Community Health Care, a clinic in Bangor that works to increase access to health care for those who need it most. Earlier in the year, the Maine Board of Dental Practice finalized rules to regulate the practice of dental therapy, creating a pathway for Roesler and others to obtain licenses to practice there. The board’s actions finally implemented a law that Maine originally enacted in 2014 and amended in 2016 and 2019.

In Michigan, regulators and advocates worked throughout 2020 to develop dental therapy licensure regulations so that these providers can help bring care to the 1.6 million state residents living in areas with limited access to dental care. In September, Pew joined other leading advocates in supporting the Michigan Department of Licensing and Regulatory Affairs’ proposed requirements and educational standards for dental therapists. These regulations will allow licensed dental therapists from other states to move to Michigan to work and will give prospective practitioners a clear path to education, licensure, and employment.

Evidence of dental therapy’s benefits continued to build

New research further demonstrated dental therapy’s benefits to patients, practices, and underserved communities. In particular, a new quantitative study, funded by Pew, shows that clinics in Minnesota that employed dental therapists saw more patients, provided more services, and increased gross revenues after integrating these providers into their teams. The research, based on data from more than 76,000 patients who made over 250,000 visits to Minnesota dental clinics from 2009 to 2019, shows how practices can use dental therapists to increase patient caseloads and revenues while providing care to underserved people, including those receiving Medicaid benefits.

Another analysis, published in the Community Dental Health Journal in August, assessed the impact of dental therapists in Alaska’s Yukon-Kuskokwim Delta region. The study, partially funded by Pew, found that children and adults living in communities with more access to dental therapists had fewer emergency dental visits. Reducing visits to emergency departments for dental care is critical: Care provided in hospital emergency departments for preventable dental conditions is often costly and inefficient. The study reinforces earlier research about the impact that dental therapists can have on improving health outcomes while lowering the overall costs of care.

Although the COVID-19 pandemic created serious challenges for dental providers, dental therapy made important strides in 2020. The strong momentum is anticipated to continue in 2021, when at least 10 additional states will consider legislation authorizing dental therapists to practice, and others will finalize regulations to license these providers. The new year also will see the launch of additional training programs to educate these crucial members of the dental team. Together, these efforts will help make affordable dental care more accessible to everyone who needs it in the United States.

Kristen Mizzi Angelone is a senior manager with The Pew Charitable Trusts’ dental campaign.