Missisouri's oral health is in a pretty bad shape. But it also suffers from a serious shortage of dental professionals. A way out could be to allow dental therapists to practise in the state, some feel. But dentists don't seem to be too very happy with the idea.
A dental therapist is a licensed dental auxiliary who specializes in treating children's teeth and oral hygiene. Local dental regulations determine the duties therapists are able to perform. Typically, therapists under the prescription of a dentist are licensed to examine children's teeth, administer restricted techniques of local anesthesia and take radiographs.
A state like Missouri would be well served with these paramedics. The Centers for Disease Control and Prevention ranked the state 47th in terms of the percentage of the population that visited a dentist last year.
The Missouri Department of Health and Senior Services said in a report back in 2005,
"While most dental disease, including tooth decay, is preventable, the prevalence of decay in Missouri's children has increased over the last five years, and certain groups continue to suffer disproportionately from dental disease - including both low-income and minority children. Two major factors affect an individual's overall oral health status: their disease rate and their ability to access and obtain dental treatment. Unfortunately, those individuals at highest risk of dental disease are also the least likely to have access to routine professional dental care."
Among its findings then were -
Tooth decay is a significant health problem for Missouri's children.
Many children in Missouri are in need of dental care.
Many children in Missouri are attending school with infection or pain from dental
While dental sealants are a proven method for preventing decay, the majority
of Missouri's third grade children do not have access to this valuable preventive
African-American children's oral health status and access to preventive dental
sealants is less than the general population.
The oral health status of children from low-income schools and access to
preventive dental sealants is less than the genera l population.†
The report went on to note, "This needs assessment demonstrates that we still face many barriers to improving the oral health of children in Missouri. We are seeing more dental disease among children, and we have fewer dentists in the state than we need to provide essential preventive and restorative services. In order to reverse these trends, we need to mobilize resources, including both public and private oral health care providers."
The situation does not seem to have changed since.
Writing in Columbian Missourian newspaper, Caitlin Hartsell, a public health graduate student at Washington University, feels if only the state were to allow dental therapists to practice, things could be far different.
The dentists are of course looking at askance at any kind of 'para' professionals. But studies have shown dental therapists can acquit themselves well and they cost less - a very important factor for disadvantaged sections.
Dental therapists, because they require less training, are able to provide comparable care for a wide range of dental services at a more affordable rate. Those who need more than basic drilling and cleaning can be referred to a professional dentist, Hartsell argues.
Dental therapists have been successful in England, Canada and Australia at providing quality dental care, she adds.
But the Missouri Dental Association has thus far been speaking only of educating the people on the importance of dental health and doesn't address the shortage issue. A dentist contends, "Distribution is a problem, but that is determined by the market. I have to work to stay busy in my two offices. Adding a "dental therapist" will not solve the access issue. Going in for a dental visit is several times cheaper than a medical visit. In general, people don't go for dental visits unless they are in pain. This is the real reason for low numbers. Only a small portion of patients can say they have no access. A dental visit doesn't cost more than a car payment..."