This blog is cross posted from the American Dental Therapy Association's blog.
Although access to quality health care services is essential to overall well-being, dental care remains inaccessible to many in the United States. Dentists who advocate for dental therapy are building the momentum to bridge this gap, particularly for underserved populations. These dedicated professionals, often with decades of experience, advocate for change in the dental industry. Integrating dental therapists into the workforce has been a critical part of bridging the gap in oral health care.
Dr. David Gesko, a recently retired dentist who held the Senior Vice President/Dental Director role at HealthPartners in Minnesota for 16 years, advocates for dental therapy. His advocacy began early in his tenure at HealthPartners when he successfully lobbied the State legislature in 2009 to pass legislation allowing dental therapy in Minnesota. His efforts have helped improve dental care access for countless individuals.
Dr. Gesko defines dental therapy by "likening it to the medical profession; like nurse practitioners and physician assistants, dental therapists are team members in the dental care team that "extend" access to care, especially to the underserved, allowing dentists to practice at the "top" of their license." He describes his advocacy for dental therapy as "swimming an upstream flow," as it required strong dedication, drive, and stamina to make a difference and improve oral health care for all. Some in organized dentistry are against dental therapy, just as some were against the dental hygienist profession. Yet, we understand the importance of a dental hygienist on a dental team. Likewise, dental therapists are as valuable to a dental team as nurses and physician assistants are to practitioners, Dr. Gesko emphasizes.
Furthermore, Dr. Gesko has had the opportunity to hire many dental therapists in his practice in Minnesota and emphasizes that they are seasoned, valued members of the oral health care team. He describes his experience working with dental therapists as a joy: "It was a joy working alongside each therapist, and I had the pleasure to do so!" Dr. Gesko loves being a dentist and expresses a strong sense of satisfaction when seeing patients needing oral health care. He emphasizes that dental therapists are a tool to care for more people. With intense passion and advocacy, Dr. Gesko wishes to live to the time when all 50 states have dental therapy and has strong faith that it can happen.
Another trailblazer in the field is Dr. Todd Hartsfield, a dentist with over 53 years of experience. Dr. Hartsfield states, "In my 53rd year of dental practice, I never fail to get excited talking about dental therapy." Dr. Hartsfield has always had a strong interest in public health and community based work. His journey with dental therapy began in 1974, when he was selected as one of the original supervising dentists for the Saskatchewan Dental Plan, North America’s first school-based dental program to utilize dental therapists. Dr. Hartsfield went on to be an instructor at both Canadian dental therapy training schools and spent 20 years in Canada training, supervising and working alongside dental therapists. He has worked in Arizona to promote its expansion and enhance access to dental care for underserved communities. Dr. Hartsfield has also contributed in developing dental therapy education curriculum in Alaska and visited the Alaska training school with a group of dentists to observe their training.
Dr. Hartsfield expresses that having a dental therapist on the team is a win-win situation. Why would we refuse someone from getting the care they need? One common misconception Dr. Hartsfield addresses is the ideology that dental therapists perform low-quality work. However, that is not the case. However, the opposite is the case. Because dental therapists train in a limited number of clinical procedures, they perform these procedures many more times than a dental school student and become highly skilled in these procedures due to the many repetitions. Dr. Hartsfield visited the Alaska program with other dentists and stated, "I was blown away by their high-quality work."
Moreover, Dr. Hartsfield encourages everyone to visit the program and see the quality of work firsthand. Dental therapists are creating a more equitable and accessible dental care system. Dr. Harstfield has witnessed patients who, inspired by the care they received, want to become dental therapists to give back to their tribal communities.
Dr. Dane Lenaker, a dentist from Alaska, has also been a strong advocate for dental therapy. He has practiced in Bethel and Juneau, Alaska since 2009, working with dental therapists throughout his career. Dr. Lenaker discusses patient satisfaction when treated by a dental therapist. "Patients in remote villages are happy to see a DHAT," as no dentists exist in these communities. Dr. Lenaker works in Alaska, where having a dental therapist as part of an oral health care team is now the standard. He understands the challenges and struggles faced by communities in remote villages. Dr. Lenaker says the healthcare community should "continue to be patient-centric with decision making and do what's best for the community."
These dentists and many others understand dental therapy’s critical role in addressing oral health disparities. Dental therapists, under the supervision of dentists, provide preventive and routine dental care, allowing dentists to focus on more complex procedures. This model improves access to care, helps alleviate the gaps in dental practices, and reduces patient costs.
Despite dental therapy's proven benefits, advocacy efforts continue to face challenges. Some argue that dental therapists provide low-quality care despite their rigorous training and supervised practice. However, studies have shown that dental therapists can provide high-quality care comparable to that of dentists, particularly in preventive and routine services.
Dentists who advocate for dental therapy are not only pushing for change within their profession but also advocating for their patient's well-being. Expanding access to dental care improves overall health outcomes and quality of life for individuals and communities.