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Article: Kellogg Foundation tries to Justify Dental Therapist Program DR. JERRY GORDON
Kellogg Foundation tries to Justify Dental Therapist Program

In April of this year, 2012, The Kellogg foundation funded a 460 page report in an attempt to justify the use of Dental Therapists, in place of dentists, for irreversible surgical dental care. Although the report touts 54 countries that have used non-dentists for treatment, there was no documentation about the treatment or outcomes in more than half of these countries. The ponderous document is riddled with contradictions, but one illustrative example is found in the beginning:

Literature on legislation, registration and licensure of dental therapists is sparse for most countries. Since most countries limit dental therapists to governmental service, they are not necessarily licensed or registered. (A Review of the Global Literature on Dental Therapists, Nash, p.5)

The literature does not document any issues of safety or harm as a result of care provided by dental therapists. (A Review of the Global Literature on Dental Therapists, Nash, p.6)

In other words, the authors of the study admit that they can't confirm if a therapist is licensed or registered, but yet we should believe that same literature that no harm came from the treatment of these therapists?

The main problem with the dental therapist program is that someone with a high school diploma and two and a half years of training can begin doing irreversible surgical treatment on patients without the direct supervision of a dentist. Dentists are required to attend three or four years of college with a heavy concentration of science (including two semesters of Biology, General Chemistry, Organic Chemistry, Physics and Calculus), and four years of dental school before practicing dentistry. Many dentists then do at least one more year of dental residency before treating patients unsupervised. There is no way you can compare a person who has taken a two year and a half year program to a dentist who has had nine years. (What does it take to be a dentist?)

The Kellogg study is replete with references of the supposed safety, increased access, and potential for decreased cost of dental care as a justification for why the dental therapist is needed. We are supposed to be comforted by the fact that these therapists will treat primarily children in underserved areas. I'm not sure I feel good about a 20 year old kid giving injections, drilling teeth and performing oral surgery on anyone one, least of all those in the most need of real help.

There are options available for those who cannot afford dental care or are in underserved communities. The least costly methods include community water fluoridation, education and prevention. Dental treatment can be rendered at an area dental school or teaching hospital and many states have programs available to aid these patients. A good local example that I am involved with here in Pennsylvania is The Bucks County Health Improvement Partnership Children's Dental Program. In all of these programs, a licensed dentist is treating of supervising all patient care.

The Dental Therapist model is seriously flawed and these practitioners will end up harming the dental profession and the people they are trying to help.

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Dr. Gordon is the dental columnist for the Bucks County Courier Times. He has published more than 300 articles since 1998. Dr. Gordon was recently asked to provide commentary about mid-level providers for the influential dental journal Dental Abstracts.

Dr. Gordon responds to an article in Dental Abstracts challenging his views.

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