The AAPD has long focused its attention, resources, and advocacy efforts on improving the oral health and access to quality dental services for children who have the highest risk of developing dental decay. A major component of AAPD’s advocacy is focused on the development of oral health policies and evidence-based clinical practice guidelines that promote the delivery of safe, comprehensive oral health care within a Dental Home. The Dental Home model is based on dentist-directed care, which means the dental team works under the direct supervision of a pediatric dentist to increase the dental office’s capacity to serve more children while also preserving quality of care.
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In this article published by the Journal of Public Health Dentistry, authors Simon et al. provide information on current state-level policies on dental therapy and discuss the future of dental therapy in the United States.
View the article here.
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Maryland dentists participated in focus groups to assess attitudes and concerns about access to oral health care for underserved populations and the perceived viability of dental therapy as a solution. The majority of dentists strongly oppose the use of dental therapists to address currently-unmet dental health needs and would not use dental therapists in their own practices.
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This article provides a standardized definition of a patient-centered dental home: “a model of care that is accessible, comprehensive, continuous, coordinated, patient‐ and family‐centered, and focused on quality and safety as an integrated part of a health home for people throughout the life span.” With this definition, we now have a standard framework to measure and improve quality of dental care in a way that is aligned with that of a patient-centered medical home.
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Tennessee dentists’ perceptions on the Dental Therapist Workforce Model were surveyed. The study results indicated that while dentists believed they have a responsibility to care for the underserved and that the model would help improve access, most had negative opinions on how dental therapists affected both the quality of care and patient perceptions of dentists.
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Minnesota dentists were surveyed on their attitudes towards the utilization of dental therapists. The survey findings indicate that most dentists opposed therapists performing extractions and had mixed opinions on other procedures. Moreover, most dentists did not believe that dental therapists will alleviate disparities in access to dental care.
Click here to view the survey results
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Dr. Anthony J. Hilleren, a solo practitioner in West Central Minnesota, presented Legislative Testimony on the Minnesota Dental Therapy Model to the state-level Health Services Committee in Bismarck, North Dakota, on September 21, 2016. Dr. Hilleren discussed his personal experiences in working with a dental therapist and presented a straightforward evaluation of the effect of dental therapy on increasing access to quality oral health care for underserved populations in Minnesota.
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The Academy of General Dentistry (AGD) discusses how the Minnesota Dental Therapist Model has impacted access to dental care since its passage in the state legislature in May 2009. The authors report finding no evidence that the emergence of dental therapists has resulted in cost savings to the state, more equitable distribution of dental health professionals, or improved access to care for low-income, uninsured, and underserved populations in Minnesota.
AGD Impact 5 2016 Midlevel Provider PDF
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This study compared the prevalence of Early Childhood Caries (ECC) in Medicaid-enrolled children with an established dental home and those without one. The findings suggested that establishing a dental home, especially for low-income populations, helps prevent ECC and cariogenic feeding behaviors.
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This paper explored the financial impact of earlier vs. later dental intervention in children. Children whose first dental visit occurred after 4 years of age needed an average of 3.58 more dental visits than children whose first dental visit occurred before age 4, totaling an average of $360.13 dental costs over the next 8 years.
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When examining solutions to mitigate dental disease and the crisis of access to care, a question is frequently raised: "Is some care better than no care?" The purpose of this article by Jessica De Bord, DDS, MSD, MA, was to examine whether the premise of some care being better than no care is ethically justifiable, and how the pediatric dental profession can balance the need for access and the need to provide appropriate, quality care.
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In this special commentary, Dr. J. Timothy Wright addresses the systematic review requested by the ADA’s House of Delegates to assess whether mid-level providers can provide dental services in a cost-effective manner, and whether their introduction into the dental workforce will improve oral health. He concludes that, while the cost effectiveness of different workforce models has been analyzed hypothetically, there is little actual data on the cost differentials among different workforce models. Additionally, comparison of outcomes in populations treated within the different workforce models suggests that dental therapists do not lower the population’s dental caries rates.
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This study evaluates the potential economic effects of employing dental therapists in general practices, such as whether substituting dental therapists for dentists in the U.S. dental care delivery system would lower the cost of delivering dental services and address access disparities to patients of all ages, including children. The economic analysis suggests that the potential impact of dental therapists in private general practices would be negligible.
This article appears on the AAPD website with the permission of author Dr. Tryfon Beazoglou and the Journal of Dental Education.
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This study explores the attitudes and perceptions of dental school faculty members who are responsible for preparing new dental therapists to practice. The research found that dental faculty members participating in the study believe that dentists have a personal responsibility to care for the underserved, but do not agree that the dental therapists are part of the solution to improve access. Moreover, there was a clear divide between part-time faculty and full-time educators with regard to their opinions on the role of dental therapists. However, there was an overall consensus that dental faculty members have a commitment and obligation to educate future dental therapists, regardless of their personal position.
This article appears on the AAPD website with the permission of author Dr. Naty Lopez and the Journal of Dental Education.
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In this Second Opinion article, Rhea M. Haugseth, D.M.D., argues that a two-tiered standard of care should not exist for our nation’s most vulnerable children. Services to this high-risk group should not be provided independently by non-dentists with less education and experience than accredited dentists, especially given that evidence-based research to support the safety, efficiency, effectiveness, and sustainability of such delivery models is not available.
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This study examined the relationship between delegation patterns and productivity, efficiency and practice income to identify the most effective patterns of delegation. The study found that delegation in general, as well as delegation of specific procedures/activities to dental hygienists and assistants, had an important effect on gross billings and patient visits. Similarly, delegating specific procedures/activities to dental hygienists and assistants had an important effect on the clinical efficiency of a general dental practice based on gross billings. One of the most powerful effects of delegation was in practice net income with an average difference of over $100,000.