September 13, 2017

Proponents say they're closer to creating new class of dental providers

Sen. Harriette Chandler, D-Worcester, is a sponsor of a bill to create a new class mid-level dental providers in Massachusetts, which proponents say will increase access for the underserved.

Lawmakers who favor a legal expansion of the scope of dentistry work so that more patients can be served say they are gaining ground on Beacon Hill.

"I'm very proud that the fact is the dentists are at the table with us, talking about this," Rep. William Pignatelli, who represents many rural communities in Berkshire County, said before a Tuesday hearing on legislation authorizing a new type of professional, a dental therapist. "This wasn't happening a year ago, but it's happening today. This mid-level practitioner, no pun intended, will fill the gap for so many folks who are in need of health care."

Supporters of the bill, which is sponsored by Sen. Harriette Chandler, D-Worcester, and others, say 47 percent of children on MassHealth, or 290,000 kids, did not see a dentist in 2014, while scores of low-income individuals, including seniors, are going without care and losing their teeth.

Health and Human Services Secretary Marylou Sudders said at the hearing that establishing the new mid-level practitioner is "the right thing to do." She told the Joint Committee on Public Health it would yield "modest savings" and help people avoid expensive, stressful emergency room visits for oral health.

Gov. Charlie Baker proposed creating a mid-level dental therapist position in an amendment to this year's budget, and Sudders said the administration prefers Baker's language but "fully supports the intent of" Chandler's bill.

"The differences are primarily technicalities, and we know that by working together, we can resolve this," Sudders said.

Separate legislation, backed by the Massachusetts Dental Society, poses a different approach to creating a dental therapist program. One sticking point between the two bills is the level of supervision for dental therapists.

The society's bill, sponsored by Rep. Peter Kocot, calls for direct supervision, with a dentist present, while Chandler and Pignatelli's allows dental therapists who have completed a year of residency or worked under direct supervision for at least 500 hours to practice under general supervision, which does not require the dentist's physical presence.

A poll released in May and commissioned by the dental society found 73 percent of respondents were not comfortable with remote supervision for dental procedures.


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