Vt. debates creating midlevel dental practitioners

The advocacy group Vermont Oral Health Care for All is pushing to create a state license for midlevel dental practitioners, according to a news story on VTDigger.org.

The position, which already exists in Minnesota and Alaska and is being debated in other states, would create a dental care provider who would be a step above a dental hygienist and a step below a dentist, according to the story.

The Vermont bill, S 35, is sponsored by Sen. Claire Ayer (D-Addison), chair of the state's Senate Committee on Health and Welfare.

While supporters argue that the creation of this provider will alleviate the state's dental care access problems, especially in rural areas, the Vermont State Dental Society opposes the bill.

The society contends that access-to-care issues are not caused by a shortage of dentists but rather how dentists are distributed geographically and how Medicaid compensates them. Also, the society has raised concerns about whether these practitioners would get sufficient training to perform certain surgical dental procedures. Finally, they note that nothing in the bill requires these practitioners to serve in rural areas.

The supporters of the bill contend that while the scope of the midlevel providers' service will be limited, allowing supervising dentists to have a final say over what procedures are performed, these providers enable a practice to accept more Medicaid patients. Also, graduates of Vermont Technical College, which has signed on to provide the curriculum for the dental practitioners, are predominately local.

The certification for a dental practitioner would require an additional year of classes after the three-year program to become a hygienist and 400 hours of clinical training, according to the story.