Michigan House Considers Licensing Dental Therapists

Published December 9, 2018

More than two million Michigan residents live in counties with dental shortages, according to the U.S. Department of Health and Human Services. Often, residents of these underserved areas seek oral health treatment at emergency rooms, which costs U.S. taxpayers nearly $58 million per year.

In 2009, Minnesota became the first state to license dental therapists. As a result, one-third of the state’s residents experienced a reduction in wait times for oral health care services. Since then, Alaska, Maine, Vermont, and a native tribe in Washington State have all followed Minnesota’s lead in lifting onerous regulations on dental therapists.

Michigan lawmakers introduced House Bill 541 in September 2018 to allow licensing of dental therapists.

Ounces of Prevention

Charlie Katebi, a state government relations manager for The Heartland Institute, which publishes Health Care News, says allowing dental therapists to practice is a way for states to avert health problems caused by lower access to dental care.

“If you can take preventative dental care measures, it prevents the problem from growing worse, so you won’t need invasive procedures later,” Katebi said. “You can save taxpayers money, since most of these people in communities with no access rely on public health programs or Medicaid.”

Better Outcomes

Thousands of Michigan residents visit emergency rooms for routine dental services each year, according to a 2016 study by the Mackinac Center for Public Policy. Some eventually encounter serious oral health problems due to a lack of access to preventative care, the study found.

Licensing dental therapists is a simple and efficient means to solve the dental care crisis in Michigan, the study’s authors claim.

“A dental therapist, supervised by a dentist, could provide basic preventive treatment and other routine care, which would likely reduce the number of emergency room visits for dental conditions,” Michael Van Beek and John Davidson of the Mackinac Center wrote in the report. “Michigan should consider this approach as it will: 1) help deal with the current identified dental care shortage areas, 2) put downward pressure on the price of dental services, making it more affordable for more people, and 3) respond to Michigan’s future demand for dental services.”

Offering Medicaid as Alternative

The Michigan Dental Association, a prominent opponent of licensing dental therapists, argues everyone deserves access to dental care provided by a dentist and increasing Medicaid spending is a better way to address the shortage.

Katebi says increasing access to dental care without allowing dental therapists to fill the gap is a pipedream.

“The choice is hardly ever between a dental therapist and a dentist,” Katebi said. “It’s typically between a dental therapist and no one. This legislation would be a significant improvement from the current situation, where families can’t access dental care because of a lack of reliable transportation, child care, or other resources due to the distance they have to travel to access care.

“Any concerns that dental therapists aren’t qualified are easy to address: Many provide care under the supervision of a dentist,” Katebi said. “And the barrier for entry into the market for dental therapists is significantly lower than for dentists, who require years of schooling and have six-figure college loan debt.”

Leonard Robinson ([email protected]) writes from Washington, DC.


“The Cost of Dental-Related Emergency Room Visits in Michigan,” Anderson Economic Group, April 2014: https://heartland.org/ publications-resources/publications/the-cost-of-dental-related-emergency-room-visits-in-michigan

Michael Van Beek and John Davidson, “Dental Therapists: A Proposal to Expand Access to Dental Care in Michigan,” Policy Brief, Mackinac Center for Public Policy, September 2016: https://heartland.org/publications-resources/publications/dental-therapists-a-proposal-to- expand-access-to-dental-care-in-michigan