A groundbreaking dentistry bill is being discussed for Oregonians. House Bill 2528 would allow a new kind of dentistry to be practiced in the state: Dental therapy.
With a smaller scope of care than dentists, but larger than dental hygienists, dental therapists would make dental care accessible to a wider variety of communities, including underserved rural and tribal communities.
Proponents of the original bill feel that increased access should be the focal point when it comes to the scope of dental therapists’ work. However some opponents say that the bill gives dental therapists too much freedom.
Although the bill stipulates that dental therapists must have a contract with a licenced “supervising dentist” in the state, it leaves the level of supervision for any given procedure up to the dentist. Some opponents have raised concerns about the potential for complications with certain dental procedures if a licensed dentist were not nearby.
A proposed amendment has limited the scope of what dental therapists could do, require them to have liability insurance of their own, and primarily be devoted to underserved populations. Dr. Scott Hanson raised the idea that certain surgical procedures should at least be done under “indirect supervision” where a dentist is in the same building, if not “direct supervision” where a dentist is in the same room. With this amendment, only limited procedures like exams, X-rays and emergency palliative treatment for dental pain relief can be performed by a therapist unsupervised.
Some feel that this amendment would be too restrictive though. For many proponents, the draw of this bill is that it would put dental providers where there would otherwise be none. By requiring the direct or indirect supervision of a licensed dentist for most procedures, this expansion cannot be achieved.
Amy Coplen, program director at Pacific University’s School of Dental Hygiene Studies, urged lawmakers not to amend the bill and over-regulate dental therapy. Rather she called upon them to “trust the competent and highly educated dentists of Oregon to delegate safely and to oversee the dental therapists work.” She argued that further restrictions to the bill would simply continue to limit access to dental care.
As HB 2528 states, “good oral health is an integral piece of overall health and well-being.” Both proponents and most sceptics of the bill-as-written can agree that spreading access to dental care is a worthy cause, and the legalization of dental therapists’ practice is one way towards that goal.
By Ardea C. Eichner