Overview for the Rural Health Advisory Committee, March 18, 2014
“Early Impacts of Dental Therapists in Minnesota”
MDH /Board of Dentistry Report to the Legislature, February 2014
SUMMARY
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Although the dental therapist workforce is in its infancy, this preliminary study finds promising
signs that dental therapists are improving access, especially for low-income Minnesotans, and
providing quality care.
Early employers of dental therapists report that once integrated into the practice, dental
therapists increase dental team productivity, improve patient satisfaction and save costs.
Ongoing research and system development are needed to better understand the impact of
dental therapists and advanced dental therapists (who can practice more independently), and
how best to expand the professions.
BACKGROUND
Why and how was the report created?
• 2009 legislature directed the Board of Dentistry (w/MDH and DHS) to evaluate dental therapist
impact on patient safety, access and cost.
• Part of first-in-nation state legislation authorizing the licensing of dental therapists and
advanced dental therapists.
• Involved survey of patients, interviews at “early adopter” clinics, and other data.
Why is the report important?
• MN is the first state to license dental therapists. (In Alaska dental therapists work under tribal
authority, and 54 other countries use dental therapists.)
• This first official government report will be widely used in MN and in the numerous other states
considering similar legislation, as those involved look for experience with this new occupation.
FINDINGS AND RECOMMENDATIONS
The dental therapist workforce is still in its infancy, but growing.
• The first dental therapist was licensed in mid-2011 (2 years after the enabling legislation was
passed) and the first advanced dental therapist was certified in February 2013.
• When this study began (Aug 2012), there were 5 licensed dental therapists; by February 2014,
there were 32 dental therapists and 6 advanced dental therapists.
• Most clinics who’ve employed a dental therapist for at least a year are considering hiring
additional dental therapists.
Dental therapists appear to be practicing safely and effectively.
• In 2+ years, four complaints have been filed with the BOD against dental therapists, two of
which were resolved without BOD action and two of which are pending. None were directly
related to patient safety.
• No disciplinary actions have been taken by the BOD against dental therapists.
• Clinics report improved quality and high patient satisfaction with dental therapists.
Dental therapists appear to be increasing access.
• Dental therapists at the study clinics, many working part-time, served 6,338 new patients.
• On average, 84 percent of these new patients were enrolled in public programs (important
because MN law requires that dental therapists serve primarily low-income, uninsured and
underserved patients, or work in dental shortage areas).
• Travel time and wait times have decreased for some patients.
Clinics report an array of additional benefits from having dental therapists.
• With Medicaid rates the same for dentist and dental therapist services, there is not an
immediate savings to the state on each claim; however, the differential between state rates and
clinics’ lower personnel costs for dental therapists appears to be contributing to more patients
being seen. There may also be state savings in ER spending.
• Cost savings are allowing clinics to add chairs and see more underserved patients.
• Dental therapists increase dental team productivity: they allow dentists to do more complex
procedures, give more flexibility to schedulers, serve as “glue” to dental team.
• Dental therapists led to lower appointment fail rates in some clinics.
• Dental therapists may reduce unnecessary ER visits, though more evidence of this is needed.
Report recommends more research, improved payment systems, and how-to support for prospective
employers.
• The state and others must continue to document the growth and development of dental therapist
in Minnesota, especially as more dental therapists and advanced dental therapists enter practice.
• Payers should work to develop consistent approaches to identify, enroll and credential dental
therapists.
• Best practices and lessons learned should be provided to prospective employers so they can more
quickly become ready to hire dental therapists.
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