Text and WGBH podcast:
What has been happening with the rise of such non-physician clinicians as nurse practitioners and physician assistants is now happening in dental care, too, with the appearance of “dental therapists”. They work in the space between dentists and dental hygienists.
It’s a matter of healthcare access and cost.
Many middle-class patients forgo dental care because it is very expensive, in part because dentists have demanded and gotten very high incomes. Consider that the average net income for a general dentist exceeds $180,000 — more than the average of around $170,000 for primary-care physicians. In some places poorer people on Medicaid can get dental care, though such access can vary quite a bit across America.
Further hurting access is that dental insurance, if you have it, usually provides very skimpy coverage, forcing most patients to make very large out-of-pocket payments. It’s enough to scare a lot of people away from getting the treatment they need. And course poor dental care can lead to other health problems, including heart disease.
So some states, although often opposed by dentist organizations fearful of reduced incomes for their members, are authorizing a new classification called “dental therapists” to provide routine care at considerably lower prices than those charged by dentists.
We’d bet that pressure from payers will lead to a rapid expansion in the number of this new kind of dental practitioner. We may even see them soon in retail clinics run by CVS and other drugstore chains.