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The Nevada Legislature as seen on May 16, 2017. (David Calvert/The Nevada Independent)

By Lancette VanGuilder

Senate Bill 366 is an important bill designed to address the oral health crisis in our state. Staggering rates of tooth decay, gum disease, oral cancer and dental related emergency room visits are prevalent in our state. Nearly the entire state of Nevada has been classified as a dental healthcare professional shortage area by the US Federal Government (HRSA), as well as the state of Nevada Division of Public and Behavioral Health. This includes urban, rural, tribal and frontier areas. Nevada currently ranks 47th in the nation for dental habits and care and 49th in the nation for children’s dental health. Data continues to show the need will grow as Nevada grows with the projection of a shortage of dentists.

To address the critical oral health needs and the shortage of providers in Nevada, Senate Bill 366 proposes to create a mid-level provider – similar to an Advanced Practice Registered Nurse or Physician’s Assistant in the medical field – known as a Dental Therapist. Dental Therapists have been recognized by the Commission on Dental Accreditation (CODA) as a safe and effective model of care. CODA is the only agency that accredits all dental, dental therapy and dental hygiene programs in the country. In order to practice as a dental therapist, a provider must graduate from a nationally accredited program, pass national and regional board examinations, obtain professional licensure, be regulated by the Nevada State Board of Dental Examiners and maintain continuing education; the same process that currently exists for dentists and dental hygienists.

The provisions of SB366 are focused on high quality patient care and patient safety. Dental therapists are required to work with a dentist and must have a written agreement outlining the duties that they can perform. They must perform hundreds of hours of practice supervised by a dentist before being allowed to work without direct supervision. The care a dental therapist is allowed to provide is limited in scope to well within their education, licensing and experience. And dental therapists work as part of a care team and are required to refer patients to a dentist when the patient needs a different level of care.

In the 10 years that dental therapists have been practicing in Minnesota, there has not been one documented case of disciplinary action against dental therapists. Dental therapists are geographically distributed throughout the state in proportion to the state’s population and are a diverse workforce with high employment and career satisfaction ratings

A review of over 1,100 academic papers conclude that dental therapists may provide safe and cost-effective treatment for children and national polls show that 81% of people support a new midlevel dental provider in their state. Dental therapy bills across the US have passed with bipartisan support.

Wendy Madson from the Healthy Communities Coalition of Lyon and Storey County has seen the effect on lack of access to dental care in her community, She states:  “It should be understood that this effort will require multiple layers of approach, from education, school-based services such as varnish and sealants, continued volunteer outreach restorative efforts and an additional provider, the Dental Therapist who can provide greater access at a lower price point to join forces within the collaborative effort. Together, we can create change and better serve our communities.”

SB366 seeks to increase access to and affordability of dental care for all Nevadans, regardless of socioeconomic background. The Nevada Dental Hygienists Association recognizes that all Nevadans deserve the same level of care and access to the entire practice of care team. Removing barriers and allowing dental care providers to practice to their level of education and training is a cost effective and feasible way to improve access to oral health services, reduce dental pain and suffering and reduce oral health disparities in our state.

Lancette VanGuilder is a past president of the Nevada Dental Hygienists Association and a past recipient of the Nevada Dental Hygienist of the Year award.

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