Accurate diagnosis is vital to properly treat an ailment. This is true for dentists and for legislators. I do a patient no good, for instance, if I pull a tooth when a filling is needed.
The right diagnosis is also necessary before we can knock down the barriers that rural and low-income Arizona families face in receiving oral health care.
An out-of-state foundation sees access as a workforce problem. The state doesn’t have enough dentists, it argues, so it wants legislators to create a new mid-level position. These dental therapists, with only three years of post-high-school education, could perform irreversible surgical procedures such as cutting and removing teeth. This, the out-of-staters say, will solve the access problem.
They’re wrong. Arizona has no shortage of dentists. There are 15 percent more dentists practicing in the state today than 10 years ago – a net increase of 599 dentists. And we already have more dentists per capita than the projected national average by 2035. Adding another layer of health providers, with all the new costs that entails, would not solve access issues.
The correct diagnosis leads to the correct answer. We need more prevention, not more drilling. Here’s a better prescription:
— Gov. Doug Ducey and lawmakers can start by restoring dental care for adults using AHCCCS, which was zeroed out during the Great Recession. As a result, those suffering from tooth pain turned to emergency rooms, where there are no dentists. Doctors treated the pain or infection, but not the underlying dental problem — guaranteeing that those patients would return. That is neither financially nor morally defensible.
— Dental care for children on AHCCCS is covered, but less than half of eligible families use the benefit. We need to get more children to the dentist through education and outreach.
— Community dental health coordinators, a relatively new approach championed by Arizona dentists, show a great deal of promise. They come from the local community and understand the local culture. They can work with their neighbors to take control of their oral health, provide preventive services and connect people with dentists and hygienists, making sure they show up for appointments.
A five-year pilot project showed these coordinators make a real difference. Rio Salado Community College, which provides the training, just enrolled its second class. Let’s give this time to work.
— Teledentistry is another answer, also recently approved by the Legislature. This allows dentists to extend their reach into remote areas, removing another barrier by erasing the need for families to make repeated, long trips to a city.
I am a lifelong Republican who believes in free-market solutions. Those places that have experimented with dental therapists have found they can survive only with extensive government subsidies. The free market does not see them as a solution.
This is not surprising because adding dental therapists rarely address the real barriers to seeing a dentist. The right diagnosis leads to the correct treatment: restore AHCCCS benefits, get children to the dentist and give community dental health coordinators and teledentistry time to work.
— Dr. Gary Jones practices in Mesa and is a past president of the Arizona Dental Association.