Tip Sheets

Background and resources for covering the dental therapist movement

By Mary Otto

The dental therapist model got its start in the 1920s in New Zealand and is now well-established in many developed countries, including the U.K., Australia and the Netherlands.

In the U.S., dental therapists began offering care on tribal lands in Alaska in 2005 as part of a longstanding federally authorized program that trains residents of Alaska Native tribal villages to provide basic care to their neighbors.

In 2009, Minnesota became the first state government to pass legislation authorizing the model. Dental therapists are now working in underserved areas of the state, as Stephanie Dickrell reported for the St. Cloud Times.

Maine and Vermont also have laws in place that allow dental therapists, although they are not yet working in those states.

Dental therapist programs have been launched by tribal communities in Washington and Oregon. Journalist Will Drabold took a look at the tribal effort in Washington for the Seattle Times. 

Other states are considering giving the model a try.

“States such as Florida, New Mexico, North Dakota, Washington and Wisconsin are now considering legislation,” wrote Jane Koppelman, senior manager for the Pew Charitable Trusts’ dental campaign in this January 2019 column, Efforts to Expand Access to Oral Health Care to Continue in 2019.

Update: House Bill 308 is on its way to  New Mexico Governor Lujan Grisham's desk. The bill would help people who are low-income, publicly insured, uninsured or living in rural and tribal areas have access to care from a dental therapist.

Technical schools in Vermont and Washington are expected to move forward with plans for training programs for the providers, Koppelman wrote.

The shortage of care in thousands of U.S. communities is helping to drive the dental therapist movement.  

The U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA)has developed shortage criteria that are used to designate Health Provider Shortage Areas (HPSAs) for primary medical care, dental and mental health providers nationwide. HPSAs may be urban or rural areas, population groups, or medical or other public facilities.

As of January 15, there were 5,834 federally designated dental health provider shortage areas across America, according to HRSA. The HRSA Data Warehouse will allow you to see if your community is among them.

The push for dental therapists took a significant step forward in 2015, when the Commission on Dental Accreditation (CODA), the agency that accredits dental and dental-related education programs, voted to adopt training standards for dental therapy related programs nationwide.

The move, which came in the wake of urging by the Federal Trade Commission, opened the way for accredited dental institutions to train the auxiliaries.

Nonprofits such as the Pew Charitable Trusts, Community Catalyst and the W.K. Kellogg Foundation hailed the step.  All three organizations have continued to back grassroots efforts to put dental therapists to work in states and maintain libraries of research and analysis that support the model.

The American Dental Association, which criticized CODA’s decision to move forward with accreditation for dental therapists, has remained opposed.

The ADA maintains that only dentists have the skills to perform what it calls irreversible procedures such as drilling and extracting teeth. The organization, which, in 2019 counted more than 161,000 dentist members nationwide, calls for increased spending on public dental programs and loan forgiveness for new dentists who agree to practice in underserved areas.

The ADA Health Policy Institute offers policy papers that reflect organized dentistry’s perspective on oral health issues. The think tank also analyzes public and private data to compile state report cards on dental care access and availability.