Home > Maryland Dental Access > The Solution

Maryland Dental AccessThankfully, there’s a solution on the table that would expand access to dental care. Senator Joan Carter Conway and Delegate Bonnie Cullison are advocating for legislation that would authorize the practice in Maryland of mid-level dental professionals – called dental therapists.

What are dental therapists?

Dental therapists, similar to nurse practitioners and physician assistants, can work under the supervision of a dentist as they provide preventive and routine care like filling cavities, placing temporary crowns, and extracting primary and loose, badly diseased permanent teeth.

They can work in private practices and non-profit clinics and can bring care directly to underserved populations in the community.

Their profession and their training programs have been fully reviewed and approved by the prestigious Commission on Dental Accreditation, which includes the American Dental Association as a key member.

Dental Therapists Help Dentists Extend Care To More People

Minnesota and Alaska now have dental therapists who are similar to physician assistants in the medical field and can provide preventive and routine treatment such as fillings.

Dental therapists have been shown to help dentists see more patients, decrease travel and appointment wait times, increase productivity, increase patient satisfaction and lower “no-shows.” They are highly educated and trained professionals—and like dental hygienists, dentists must hire and supervise them and can restrict their procedures.

In Maryland:

Dental therapists could work in various settings. Private practice dentists, especially in rural areas, could hire them to expand care to more people. They could also work in community health centers or mobile programs, serving kids in schools and seniors in nursing homes and assisted living centers. With a dental therapist providing more routine care, a dentist would have greater availability for more complex cases.

Evidence Supports Dental Therapy

  • More than 1,100 studies show dental therapists provide high quality care.1
  • The Journal of the American Dental Association published a study in 2011 stating that dental therapists provided high quality care comparable to dentists for procedures both can do.2
  • The Journal of the American Dental Association published a study in 2011 stating that dental therapists provided high quality care comparable to dentists for procedures both can do.
  • Dental teams employing dental therapists reduce untreated tooth decay more than dentist-only teams.3
  • Patients in MN said 76 percent of appointments were for preventive check-ups or routine treatment like fillings.4
  • A rural private practice employing a dental therapist in MN increased Medicaid patients and profits despite a far lower reimbursement rate there.5
  • Support among MN dentists for dental therapists is growing, as “most or all have jobs lined up prior to graduation.” 95 percent are employed (about half in private practice) and the number graduating is increasing.6
  • Experience in 50+ countries, AK and MN shows allowing dentists to hire them can extend care to more rural, low-income, and uninsured patients—including in schools and nursing homes.
  • The national accrediting commission for schools educating dentists and other dental providers has approved standards for dental therapy.7

  1. Nash D et al., “A Review of the Global Literature on Dental Therapists,” Community Dentistry and Oral Epidemiology (2013).
  2. Bader JD et al. Clinical technical performance of dental therapists in AK. JADA 2011;142(3):322-326.
  3. Wright JT et al. A systematic review of oral health outcomes produced by dental teams incorporating midlevel providers. JADA. 2013;144(1):75–91.
  4. MN Department of Health and MN Board of Dentistry, “Early Impacts of Dental Therapists in MN” (February 2014).
  5. Expanding the Dental Team: Studies of Two Private Practices, Pew Charitable Trusts, 2014.
  6. Presentation by Dr. Karl Self, Director, Division of Dental Therapy, University of MN, at the National Oral Health Conference, April 20, 2016; Email communication from Dr. Jayne Cernohous, Director of Dental Therapy, Metropolitan State University, to The Pew Charitable Trusts, December 7, 2016.
  7. American Dental Association, Commission on Dental Accreditation. Accreditation Standards for Dental Therapy Education Programs. August 2015