Did you know that the most recent Massachusetts data revealed that47 percent of our children — almost half of all minors across the state — had not seen a dentist in the past year? Did you know that 57 percent of seniors in long-term care facilities had been living with dental disease? The report, conducted by the Massachusetts Health Policy Commission, showed over 36,000 dental-related emergency room visits costing the state upwards of $36 million — all of which could have been prevented with adequate access to dental care. It’s not always that these folks are uninsured; many other factors come into play.
Keeping in mind these hardships and the difficulties many of our residents face when accessing dental care, I’m thrilled to report that my dental therapy bill allowing for the creation of new mid-level dental providers in the Commonwealth received a favorable report from the Joint Committee on Public Health earlier this week, on the Massachusetts Dental Society’s (MDS) annual Lobby Day at the State House. The bill, now known as H.2474, An Act to improve oral health for all in Massachusetts residents, has even received a full and complete endorsement from MDS.
In Berkshire County, we’re spread out geographically and face a lack of public transportation. We have only 2 percent of the private dental practices in the state and almost half of our practicing dentists have neared retirement. Couple this with the rising levels of student debt for graduating dentists and you get fewer young dental professionals in the county and across the state who can service these patients. Although Hillcrest Dental and Community Health Partnerships have done tremendous work to fill this gap, the fact remains that we need greater access. On top of this, most dentists in the Berkshires and in Massachusetts do not accept MassHealth due to its low rate of reimbursement – which, I believe, is the next challenge for the Legislature to address.
It has become a well-established fact by now that good dental health is a necessary and contributing factor to good overall health. Unfortunately, public policy does not always rise to meet new developments as quickly as we need it to. As many of you already know, I have been a longtime supporter of increased access to dental care in Massachusetts and have sponsored legislation engineering the creation of a new, mid-level dental provider who, much like a nurse practitioner in the medical field, would make dental care more accessible and affordable for those in our society who need it the most: low-income residents, children, and seniors.
The House bill that the Committee has moved forward came after copious hours and a long chain of discussions between myself, Chairwoman Kate Hogan of the Public Health Committee, and several key members from the Massachusetts Dental Society, during which we relied heavily on figures showing the positive effect of mid-level providers in states that have passed similar legislation, including Minnesota, Maine, and Alaska.
We have reached a compromise package that includes a required master’s degree from an institution accredited by the U.S. Commission on Dental Accreditation (CODA) for all aspiring dental therapists. Dental therapists will have the flexibility to be dually licensed as a DT and hygienist, and will be permitted to practice all dental hygiene and CODA approved procedures. After two years of practicing under direct supervision, DTs will be able to work remotely and bring their services where they are needed most, including schools, community centers, or nursing homes.
In addition, the legislation also provides a pathway towards general supervision for advanced level procedures so folks who are unable to visit the dentist’s office or whose insurance might not otherwise cover these procedures have a greater chance of being treated. The Department of Public Health will be charged with making a recommendation to the Board of Registration in Dentistry using data to measure the effectiveness and progress of dental therapists and the Board will be charged with promulgating regulations to follow through on these recommendations for general supervision.
I’m confident that the dental therapist position we have advocated will address these challenges much as they have in states where this position already exists. After passing enabling legislation in 2009, a Minneapolis-based children’s dental clinic saw an increase of 10,000 patients as soon as 2011. A 2014 Minnesota Department of Health and Board of Dentistry report showed that the existence of dental therapists translated into an overall increase in dental patients, particularly those who were previously underserved.
In addition to providing patients with more professionals, we will be creating a new course of study and career path for existing dental hygienists and brand new candidates alike to pursue a viable career in dental therapy. Accredited colleges and universities will be free to partner with community colleges and technical schools to create a new model for students of varying backgrounds to find time to successfully complete this degree.
I’m grateful to my friend and colleague, Chairwoman Kate Hogan of the Public Health Committee for her leadership and perseverance throughout the negotiation process and for co-petitioning the House bill with me this session; to MDS for continuing the conversation and making the effort to meet us halfway; and to Senate President Harriette Chandler for introducing and championing dental therapy legislation on the Senate side.
I’m indebted to our advocates for believing in and pushing this measure forward with us each step of the way. We have come a long way with this language but there is much more to get done. I have great optimism for the future of dental health in Berkshire County and throughout the Commonwealth and it is my great hope that this legislation will continue to gain traction this legislative session.
