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Kansas Advocates Of Mid-Level Dental Providers Cheer Accreditation Decision

A decision to accredit so-called mid-level dental providers by a national agency that oversees dental education programs may boost efforts to license them in Kansas.

The Commission on Dental Accreditation says that without national accreditation standards for mid-level dental providers — also known as dental therapists — the requirements would vary from state to state.

The commission assigned a committee to develop the standards that programs training dental therapists would have to meet. A progress report is expected this winter, and an accreditation program for dental therapists could be in place as early as January 2017.

Dental therapists would be trained to a level below that of a dentist but beyond the training a dental hygienist receives. They would be allowed to do some procedures, like filling cavities, that currently can only be done by a dentist.

In Kansas, advocates for allowing dental hygienists with advanced training to perform a broader range of procedures have tried for five years to convince legislators to approve changes in state law. They say the change would expand access to dental services in a state where 95 of 105 counties have a shortage of dental providers.

The United Methodist Health Ministry Fund is among the groups that support licensing mid-level dental providers in Kansas.

“We need to improve access to dental services by having a mid-level, and this decision goes a long way to saying that a branch of dentistry recognizes that can happen — that people can be trained at less than a dentist to do some procedures in the mouth that dentists now do,” says Kim Moore, president of the United Methodist Health Ministry Fund.

Moore says the commission’s decision undercuts the Kansas Dental Association’s argument that dental therapists would provide substandard care.

“What it really means to legislators is that an important organization recognized by the Department of Education to set standards for dental programs has determined that this is a legitimate profession,” Moore says. “They can operate safely when properly educated, and there are going to be national standards that can be used by Kansas to assure itself that we do the proper education.”

Kevin Robertson, executive director of the Kansas Dental Association, says the commission’s decision doesn’t mean Kansas should license non-dentists to do procedures that are now legal for dentists only.

“The policy decisions of the ADA, and certainly the KDA, are not at all influenced by what the commission does,” Robertson says.

The commission can establish training requirements for dental therapists, he says, but that doesn’t mean Kansas lawmakers need to establish a new category of license for them.

“Every state makes their own decision with regard to what dentists and allied dental professionals can do within their state,” Robertson says. “So, it really doesn’t have any validity with regard to suddenly Kansas should accept this position.”

Robertson says the new category of mid-level providers, if created, should be limited in what they could do.

“Their accreditation process does not recognize the ability of this dental therapist to do diagnosis or treatment planning, which are something that the Kansas Dental Association has been opposed to. Nor it does recognize some restorative procedures. We’re also opposed to those, as we believe those are best done by a dentist,” Robertson says.

And Robertson says the American Dental Association has taken much the same position in a statement after the commission’s decision.

Legislation to license registered dental practitioners in Kansas has been introduced every year since 2011 to a relatively cool reception from lawmakers. And while advocates were disappointed the bill never came to a vote in the 2015 session, they were pleased that it at least got a hearing.

Bryan Thompson is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team.

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