As of December 2017, more than 4.6 million Arizonans live in a federally designated dental health professional shortage area. In fact, compared to the rest of the United States, Arizona has the highest percentage of its population living in a federally-designated shortage area. And this crisis impacts every corner of our state, including large portions of all 15 counties, and all of Graham, Greenlee, La Paz, Santa Cruz and Yuma counties.
The shortage of available dental providers hits especially hard in poor neighborhoods, tribal communities and rural areas. Although children are covered for dental services under AHCCCS, sadly less than half received any dental care at all in 2016. A number of factors contribute to this crisis, but the key fact remains: Families living in rural and low-income areas are at the highest risk for poor oral health, have the fewest provider options, face longer wait times for appointments and travel farther to find a dentist. A child going without quality dental care is at much greater risk of serious health issues now and in the future.
Dental issues can also severely impact a child’s education and future success. Preventable tooth decay and the dental pain associated with it are major contributors to increased school absences, lack of confidence, poor self-esteem, and the inability to concentrate at school. While we all agree that a good education is key to pulling a child from poverty and putting him or her on the path to success, the lack of quality dental care makes those outcomes even harder.
This is why I have introduced legislation authorizing the licensure of a type of allied dental professional, called a dental therapist. By adding dental therapists to the existing team of dental care providers, we can bring more qualified dental professionals to rural and other communities in need and empower both private and nonprofit dental clinics that wish to expand their practices and serve more Arizonans. Dental therapists are proven to be an effective, and an integral part of the dental care delivery system. They have worked successfully in more than 50 countries since the 1920s, and in parts of the United States since 2004. More than 1,000 studies, reports and assessments confirm the safety and effectiveness of highly skilled dental therapists. Further, the Commission on Dental Accreditation — the national accrediting body for all dental education programs — spent six years studying the literature, reviewing the facts, and receiving public input before releasing national educational standards for dental therapists.
Dental therapists work under a supervisory relationship with a dentist, sometimes working in remote locations, or during hours when the dentist can’t be present. They communicate regularly with their supervising dentist using innovative telemedicine technologies. As professionals in a dentist-led team, dental therapists work much in the same way nurse practitioners and physician assistants do, extending the reach of physicians, allowing them to concentrate on patients with complex needs and more complicated procedures.
For the past 18 months, I have worked closely with the dental industry, health care providers, and community interests to develop this proposal. I have spoken with regional dental testing agencies, local dental educators, and reviewed countless studies on the safety of dental therapists and the impact they have had in other states to increase access to dental care for underserved children and adults. Only by working together will we be successful in adopting innovative solutions to enhance the accessibility of our existing dental care delivery model. I strongly urge my colleagues to join me in addressing this critical need. Dental therapists are a proven, actionable first step toward improving the overall health and wellness of our state, and a bright future for our children.
— Sen. Nancy Barto, R-Phoenix, chairs the Senate Health and Human Services Committee.
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