Editor's note: Helaine Smith's column, The Mouth Physician, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.
The first class of dental therapists is due to graduate in 2011 from the University of Minnesota. I truly do not see how this is going to alleviate the access-to-care problem for undeserved populations, although I know many disagree with my views from the e-mails I have received referencing my previous posts regarding dental therapists.
I would like to address some of the comments readers have sent to me. I appreciate the time they took to express their opinions and honestly believe their heart is in the right place -- except when they claim that dentists are only interested in paying back our loans.
A hygienist wrote to me to say that she is treating perio patients with high levels of C-reactive protein that have been referred to her by a physician. That is great! I am glad to hear that physicians are checking this and that they understand the link between this protein and perio disease.
I think it is going to take time for physicians to start talking regularly with their patients about the need to improve their oral health. But it is nice to know that some physicians are realizing it now and doing something about it.
So much information is available about the link between certain high-risk behaviors and our oral and overall health. But it all comes down to choice. We know we should not drink soda, but caries are rampant in rural areas due to soda consumption. We know we should not eat junk food, but obesity is at an all-time high. The same for smoking, tanning, unprotected sex, and all kinds of other high-risk behaviors. We know they are not good for us, but many of us still ignore them and continue our high-risk ways.
Will dental therapists be able to make a difference in this regard? I personally do not understand how they will be able to help a child with 20 carious teeth. Most general dentists could not handle such complex cases, which is why there are pedodontists. Is it enough to extract deciduous teeth and not do follow-through with space maintainers? Is that meeting the level of care that these children would receive if they went to a pedodontist?
An alternative solution to the shortage of dentists would be to offer more scholarships to dental students to serve two years in clinics in the rural areas and inner cities, and have more pediatric dental residency programs. Assistants should have expanded duties, and hygienists should be able to administer local anesthesia for scalings. But allowing dental therapists to drill and extract teeth is not right.
Yes, other countries have the dental therapist model, but have we stopped to look at what countries they are? Why are we trying to model U.S. healthcare after Third World countries and government controlled healthcare?
We will have to wait and see what happens in Minnesota -- an approach the dental community is accustomed to taking. Organized dentistry's slowness in reacting allowed this concept to take form. Do we really want tooth plumbers to do the jobs of mouth physicians?
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