Dental therapists with two years of intensive training provide safe, competent, and appropriate dental care, according to an independent evaluation of a pilot program in Alaska designed to expand access to dental care. The two year evaluation just completed is the first independent evaluation of its scale to assess care provided by dental therapists practicing in the U.S. It confirms that dental therapists are able to provide safe care for underserved populations.
In Alaska, dental therapists under the general supervision of dentists have been providing preventive and basic dental care to families in remote Alaska Native villages since 2006. The program evaluation conducted by RTI International of Research Triangle Park, in North Carolina, and funded by the W.K Kellogg Foundation, the Rasmuson Foundation, and the Bethel Community Services Foundation, found that dental therapists in Alaska are clearly providing safe dental services.
Severe shortages of dentists disproportionately affect low income communities and communities of color which has resulted in putting sorely needed dental services out of reach for nearly 50 million Americans, particularly in rural and underserved areas. There are 60,000 Alaska Natives living in small rural Alaska communities that are accessible only by air or water. In most villages, a dentist is available for only one week a year.
The evaluation revealed that of the 405 Alaska Natives surveyed, it was found that over half of all children have had untreated dental decay as do 60 percent of adolescents and 77 percent of adults. Tooth decay rates among American Indian and Alaska Native children are five times the national average for children from two to four years old.
“Dental therapists in Alaska are performing well and operating safely within their scope of work,” said Scott Wetterhall, M.D., RTI’s principal investigator and lead author of the evaluation report. He noted, however, that the evaluation did not assess the overall impact of dental therapists work and that there is still a tremendous amount of dental diseases and unmet dental need.
Mary Willard, Clinical Director of the Dental Health Aide Therapist Training Program in Alaska, reported that the students spend 40 hours a week in clinical training for a year on top of an intensive year of classroom training.
It was found that four of the five communities receiving dental care successfully provided preventive treatment children at high risk for cavities and adults overwhelmingly reported a positive experience with dental therapists. Although the study did not attempt to quantify changes in access to care, the survey of Alaska village residents felt that access to care had improved.
“The survey findings clearly indicate that alternative providers such as dental therapists can successfully provide good, quality dental care in areas where people can’t gain access to dentists,” said Sterling K. Speirn, the W.K. Kellogg Foundation’s President and CEO. He continued to say “Other states and tribal areas should explore the dental therapist model as a way to expand the reach of dentists.”
Internationally, dental therapists have a long history of successfully expanding high quality care to underserved children and families as part of a comprehensive system of care managed by dentists. Dental therapy has been well established for decades in more than 50 countries including those countries with advanced dental care systems similar to the U.S.
Go to www.wkkf.org/what-we-support/healthy-kids/dental-therapy.aspx for a copy of the full report and videos of the Alaska dental therapist program. For more details, email Fiona Brosnan, Alaska Native Tribal Health Consortium at fmbrosnan@anthc.org.
