One change to dental care that could save lives, money
Poor dental health affects tens of millions of Americans with 63 million live in places described as dental shortage areas; suffering from decaying teeth, toothaches and chronic dental pains. Not only does this lead to general suffering, from an economic stance work productivity is damaged across all age ranges. Moreover, high medical costs mean only 1 in 3 dentists actually accept Medicaid patients. However, states are now attempting to overcome the issues that stop both adults and children receiving proper dental care at little cost to the taxpayer. Political advocates Grover Norquist and Don Berwick see a simple solution, one that received over a 75 percent backing from Democrats and Republicans alike. They want to allow dentists to hire a variety of professionals from dental therapists to nurse practitioners who can supply preventive care and perform routine procedures that do not require dentists. This would utilize the free market at little cost, allowing dental therapists to operate without unnecessary government barriers while being able to treat more patients, offering the potential opportunity for SME’s expansion. Tragic cases like Deamonte Driver, who lost his life after receiving poor dental treatment would be prevented if dental therapists were able to operate. Subsequently, dental therapists are far cheaper than dentists, they provide high-quality care, are well educated and readily available, having existed in more than 50 countries for over a century. Should states turn to dental therapists, it would provide a simple solution to help patients, businesses and combat rising health care costs.

Tens of millions of Americans have decaying teeth, frequent toothaches and chronic dental pain. The result can be lost work productivity, missed school days and outright suffering. Many of those people — adults and children — lack access to the dental care that could help them.

Fortunately, states are beginning to embrace what The New York Times has called “a big idea” for social change: a new category of dental care providers that can mitigate many of these problems without burdening taxpayers or state budgets with bigger government or regulations.

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America lacks sufficient dental care providers. Some 63 million people live in places that the U.S. Department of Health and Human Services designates as dental shortage areas. People on Medicaid face even higher hurdles, since only 1 in 3 dentists accepts Medicaid patients. The American Dental Association acknowledges that high costs pose a significant barrier to dental care for many.

That’s why the two of us — on opposite sides of many issues, including the national health care law — have come together in support of a common sense policy that should spread to all states: allowing dentists to hire professionals known as dental therapists. Analogous to nurse practitioners and physicians’ assistants, dental therapists work as mid-level providers within a larger dental team, supplying preventive care and performing routine procedures, such as filling cavities.

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Voters across the political spectrum support the use of these new mid-level dental practitioners. In a national poll conducted in 2016 by Americans for Tax Reform 79 percent of all voters were in favor the idea. That included support from 77 percent of Republicans, 79 percent of independents and 80 percent of Democrats.

Allowing dental therapists to practice would remove an unnecessary government barrier to dental services and enable dentists, many of them small business owners, to treat more patients and expand their businesses if they so choose. It would utilize the free market at little cost to states.

In 2007, the tragic case of 12-year-old Deamonte Driver gained national attention when the Maryland boy died from an untreated tooth infection because his family couldn’t find a dentist who would treat him. Instead of an $80 procedure that could have prevented Deamonte’s death, his saga turned into a series of hospital visits that came too late, ending with the needless loss of his life, but also costing taxpayers tens of thousands of dollars through Medicaid. And yet, little has changed across the U.S. since then when it comes to dental care access. There has been a serious market failure, harming lives and raising costs. Fortunately, a market solution now exists, if only states will adopt it: dental therapists.

The lower salaries of dental therapists, compared with dentists’, reduce the cost of delivering care, making it more feasible for both nonprofit and private dental clinics to accept Medicaid payment rates for patients who depend on public programs, like Deamonte Driver did. This would allow states to do more with scarce Medicaid dollars — a win for both taxpayers and patients. Dental therapists also give entrepreneurial dentists more flexibility to expand practice hours, treat more patients, reduce costs and focus their own time on more complex procedures. That can produce more income for dentists’ practices and better health outcomes for patients.

Dental therapists give high-quality care. They are well-educated, thoroughly trained and carefully tested. The programs that prepare them must meet rigorous standards approved by the same body that oversees the training of dentists, the Commission on Dental Accreditation, which includes the American Dental Association as a member.

Dental therapists have practiced for nearly 100 years in more than 50 countries. In fact, America was late to the game. Alaska first introduced this type of practitioner to the United States in 2004. Since then, Minnesota, Maine and Vermont have passed legislation authorizing dental therapists, and Arizona, Massachusetts, Michigan, North Dakota and several other states are considering it.

Dental therapists would make a big difference in the lives of the many Americans who are struggling to find dental care. As the health care debate continues at the national level, allowing dental therapists to practice is a bipartisan solution that state legislators can adopt right now that benefits small businesses, helps patients and eases the burden of rising health care costs, including Medicaid. We are proud to stand together in support of this proven program.

Grover Norquist is president of Americans for Tax Reform. Don Berwick is former administrator of the Centers for Medicare and Medicaid Services and currently senior fellow at the Institute for Healthcare Improvement and lecturer at the Harvard Medical School.