LOW-COST
DENTAL CARE
In
remote northwestern Alaska, where dental decay is rampant, some of Stephanie
Woods’ patient suffered from toothaches for months on end.
“Raging
toothaches with swelling, something that you or I would go that day and have it
taken care of,these patients just lived with the pain. They thought it was
part of everyday life,”
Ms.
Woods is not a dentist. She is one of 15 certified dental therapists in Alaska,
the only state where non dentists may perform extractions and administer
fillings. The therapists receive two years of training. They help fill the
vacuum as Alaska has for a long time had trouble attracting and retaining
licensed dentists. Sixty present of Alaska Native children ages 2 to 5 have
untreated decay, and 20 present of Native adults over 55 have no teeth at all.
But the American Dental Association, opposes
the use of nondentists for "irreversible procedures" including
drilling and extraction, citing patient safety.Dr. Raymond Gist, the association president said,
"If you
have a person suffering from pain, that person has advanced disease, and should
see a licensed dentist without delay."
Now a two-year foundation supported study has
reignited the debate over which practitioners are qualified to provide dental
care, especially to under served populations in high poverty areas. It found
that Alaska's dental therapist provide safe, competent appropriate care. The
therapists refer cases beyond their scope to supervising dentists. The study,
financed by the W.K. Kellogg, and Rasmussen Fund examined the work of dental therapist
in five rural Alaskan communities. The positive results are consistent with
finding from overseas, where dental therapy programs are well established, said
Dr. Mary Willard, a dentist who directs the therapist training program for the
nonprofit Alaska Native Tribal Health Consortium.
Filling a vacuum in Alaska, where no dentist may pull and fill teeth.
Ten other
states, including Connecticut, are considering mid-level dental provider systems
for under served residents. These practioners can be trained for relatively
little money said Dr. Allen H Hindin, who is on the board of the Connecticut State
Dental Association said,
“Partly for
that reason the topic has become a turf issue-not just economic, but
intellectual and cultural.”
Unlike
Alaska, Connecticut has no shortage of dentist, but Dr. Bruce J. Tandy, the
state associations immediate past president, agreed that dentist were wary of
losing patients to mid-level practioners. He said,
“Many dentists don’t
understand how these individuals are going to be used, so they feel threatened.
In fact, the mid-level providers can be trained to do certain simple procedures
safely, and they would most likely work in public health clinics seeing
patients whom most dentists will never see in their offices”.
To be continued...
KARL WALLACE
To read more Karl
Wallace go to: com karlwallaceblog.blogspot.com
