Betsy Bayless: Too few Arizonans have proper access to dental care. But there are better ways to fix this problem.

Being poor should not subject people to a different standard of health care. That is why, in my eight years leading the Maricopa Integrated Health System, I worked to improve clinical quality, train more doctors  and improve equipment and facilities.

And it is why I oppose the creation of dental therapists in Arizona, the wrong answer to the real problem of access to dental care. An effort is underway to push this experimental, one-size-fits all solution.

Over the years, I have been a proponent of mid-level providers such as nurse practitioners and physician assistants. They have been welcome additions to medical care. But there are big differences. Unlike mid-level medical providers, dental therapists could perform irreversible surgery and procedures such as drilling, filling and removing teeth with only a community college education.dental laser tips

There is no shortage of dentists in Arizona.

5 better solutions than therapists

Among the better solutions:

It is not clear what problem dental therapists would address that cannot be done more efficiently by other means. We need more education and prevention, not more drilling.
 

• Restore Medicaid dental coverage. During the recession, the Legislature cut AHCCCS (Arizona Health Care Cost Containment System) dental coverage for adults. That sent more people to ERs, where they can only be treated with pain medication and antibiotics by a busy doctor, not a dentist. The underlying dental condition remains, so return trips are guaranteed. Now that times are better, emergency dental coverage should be restored. Including preventive care would be even more cost effective.
• Get more kids to the dentist. AHCCCS has comprehensive coverage for children, but the program is utilized by only 44 percent of eligible families.  A better effort should be undertaken to educate moms and dads to get their children in for routine dental check-ups and treatment.
• Support more aggressive prevention programs like fluoride varnish for kids and sealant programs in schools.dental laser tips
• Train more community dental health coordinators. These coordinators come from the local community and understand the culture. They can perform preventive procedures to protect teeth from decay, work with community residents  to take control of their oral health, and connect people with services from dentists and hygienists. Many of the coordinators are hygienists themselves. Rio Salado Community College has taken the lead in training these coordinators. Its second class just started. We need to give this program time to reach its full potential.
• Use teledentistry, approved by legislators just two years ago. Dentists can virtually connect with their dental team to extend their reach into remote areas. For families living a great distance from a dentist, the technology facilitates diagnosis and treatment planning, allowing the family to make only one trip to receive treatment.

• Arizona has no shortage of dentists, especially dentists who participate in AHCCCS. The trend lines are all positive. It is a matter of connecting the dental team with underserved populations. That starts by getting more AHCCCS children to the dentist, bringing adult AHCCCS coverage back and using technology to connect our existing dental teams.

  Dental therapists, as proposed, are not the answer. The educational requirements are insufficient. Arizona can do better, and it is already on the right path to expand access to dental care.dental laser tips