Minnesota may be the first state to allow dental hygienists to
pull teeth, begin the process of root canal, and drill and fill
teeth. The bill, SF 2895, is now in the Minnesota state
legislature. This legislation creates a new type
of practitioner called an advanced dental hygiene practitioner
or (ADHP). Under the noble guise of helping the underserved,
this bill will allow undertrained and inexperienced individuals
to diagnose and treat patients without the supervision of a
dentist in most cases. The concept of the ADHP considered in SF
2895 is dangerously wrongheaded, and shows why it is unwise to
have lawmakers with no understanding of dentistry and medicine
make fundamental changes in the delivery of care to dental
Most dentists are required to attend four years of college with
a heavy concentration of science, and four years of dental
school before practicing dentistry. Recently, New York has
included an extra year, a mandatory residency prior to receiving
a dental license, and other states are moving in that direction.
Why is the trend more education, and not less? The answer is
simple. Dentistry is a complex discipline that requires years of
training and experience to become competent. I could fill every
page of this newspaper with the potential problems and
complications that will arise if SF 2895 becomes law. In fact,
SF 2895 is the most shortsighted concept in recent memory.
Let me take just one example of what can happen if the ADHP is
allowed to extract a tooth. The first question is if the tooth
actually needs to be removed. Can it be saved with root canal?
Having never done a root canal or restored the tooth afterward
with a crown or cap, there will be no real judgment brought to
bear on the issue. What if there is swelling around the tooth?
Is it better to drain the infection first (which they are not
allowed to do), then remove the tooth, or do both at the same
time? Will the ADHP know that if the infection is not drained
that the person can die from this complication, even if the
tooth has been pulled?What happens when the simple tooth
extraction becomes difficult, and the roots break off in the
jaw? Not trained or permitted to do what is necessary to remove
the root fragments surgically, will there be a dentist or oral
surgeon available to complete the procedure in a safe and timely
manner? What will the ADHP do if they cannot stop the patient
from bleeding, or the sinus is damaged during the procedure?
These are just a few of the things a dentist must consider each
time a tooth is extracted. In fact, some dentists don't
even do extractions, opting to send these patients to an oral
surgeon, who has three to four more years of training than the
Bill SF 2895 will result in both harm and supervised neglect of
the people unfortunate enough to be treated by the ADHP. This
agenda driven legislation will not lower the cost of health
care, or improve access, and should not be enacted into law.