Academic Pediatrics
Volume 9, Issue 6 , Pages 446-451 , November 2009

Adding Dental Therapists to the Health Care Team to Improve Access to Oral Health Care for Children

  • David A. Nash, DMD, MS, EdD

      Affiliations

    • Corresponding Author InformationAddress correspondence to David A. Nash, DMD, MS, EdD, University of Kentucky, Division of Pediatric Dentistry, University of Kentucky Medical Center, 800 Rose Street, Lexington, Kentucky 40536.

Received 3 April 2009 ,Accepted 24 August 2009.

References 

  1. US Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, Md: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health; 2000;
  2. US Department of Health and Human Services. National Call to Action to Promote Oral Health: A Public-Private Partnership under the Leadership of the Office of the Surgeon General. Rockville, Md: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health; 2003;
  3. Nash DA, Nagel RJ. A brief history and current status of a dental therapy initiative in the United States. J Dent Educ. 2005;69:857–859
  4. Gehshan S, Straw T. Access to Oral Health Services for Low-Income People—Policy Barriers and Opportunities for Intervention for The Robert Wood Johnson Foundation. October 2002. Available at http://www.oralhealthamerica.org/pdf/NCSLReport.pdf. Accessed October 8, 2009.
  5. American Dental Education Association. Improving the Oral Health Status of All Americans: Roles and Responsibilities of Academic Dental Institutions. Washington, DC: American Dental Education Association; 2003;
  6. United States General Accounting Office. Report to Congressional Requesters. ORAL HEALTH: Factors Contributing to Low Use of Dental Services by Low-Income Populations. GAO/HEHS-00-149. September 2000. Available at http://www.gao.gov/new.items/he00149.pdf. Accessed October 8, 2009.
  7. American Dental Association. 2007 Survey of Dental Practice: Income from the Private Practice of Dentistry. Chicago, Ill: American Dental Association; 2009;
  8. American Dental Association. Division of Education, 2006–2007 Report. Chicago, Ill: American Dental Association; 2008;
  9. Beazoglou T, Bailit H, Brown J. Selling your practice: are there problems ahead?. J Am Dent Assoc. 2000;131:1693–1698
  10. American Academy of Pediatric Dentistry Web site. Available at: http://www.aapd.org. Accessed July 7, 2009.
  11. Casamassimo P. We need help! Pediatric Dentistry Today. 2000:36:1, 7.
  12. US Department of Health and Human Services. Health Professions Shortage Areas. Rockville, Md: Health Resources and Services Administration; 1999;
  13. Department of Health and Human Services. Health Resources and Services Administration. Shortage Designation: HPSAs, MUAs, MUPs. Available at http://bhpr.hrsa.gov/shortage. Accesssed October 8, 2009.
  14. Xu G, Fields SK, Laine C, et al. The relationship between the race/ethnicity of generalist physicians and their care for underserved populations. Am J Public Health. 1997;87:817–822
  15. Komaromy M, Grumbach K, Drake M, et al. The role of black and Hispanic physicians in providing health care for underserved populations. N Engl J Med. 1996;334:1305–1310
  16. Brown LJ, Lazar V. Minority Dentists—Why We Need Them: Closing the Gap. Washington, DC: Office of Minority Health, US Department of Health and Human Services; 1999;6–7
  17. Valachovic RW. Dental workforce trends and children. Ambul Pediatr. 2002;(suppl 2):154–161
  18. Kaste LM, Selwitz RH, Oldakowski JA, et al. Coronal caries in the primary and permanent dentitions of children and adolescents 1–17 year of age: United States, 1988–91. J Dent Res. 1996;75:631–641
  19. American Dental Association. Survey of Dental Education, 2006. 2008;Chicago, Ill
  20. Seale NS, Casamassimo P. US predoctoral education in pediatric dentistry: its impact on access to dental care. J Dent Educ. 2003;67:23–30
  21. Gehshan S, Hauck P, Scales J., Increasing dentists’ participation in Medicaid and SCHIP. Forum for State Health Policy Leadership. National Conference of State Legislatures, Denver and Washington; 2001.
  22. Henry J. Kaiser Family Foundation. Medicaid/CHIP. Available at: http://www.kff.rog/medicaid. Accessed July 9, 2009.
  23. Morris PJ, Freed JR, Nguyen A, et al. Pediatric dentists’ participation in the California Medicaid program. Pediatr Dent. 2004;26:79–86
  24. Slonkosky PW, Nash DA, Mathu-Muju KR, et al. A practice profile of board-certified pediatric dentists based upon characteristics of the dental home. Pediatr Dent. In press.
  25. Fulton JT. Experiment in Dental Care: Results of New Zealand's Use of School Dental Nurses. Geneva, Switzerland: World Health Organization; 1951;
  26. Nash DA. Developing a pediatric oral health therapist to help address oral health disparities among children. J Dent Educ. 2004;68:8–20
  27. Nash DA. Developing and deploying a new member of the dental team: a pediatric oral health therapist. J Pub Health Dent. 2005;65:48–55
  28. Nash DA, Friedman JW, Kardos TB, et al. Dental therapists: a global perspective. Int Dent J. 2008;58:61–70
  29. New Zealand Ministry of Health. Available at: http://www.moh.govt.nz. Accessed March 1, 2007.
  30. National Health Committee. Improving Child Oral Health and Reducing Child Oral Health Inequalities: Report to the Minister from the Public Health Advisory Committee. Wellington, New Zealand: National Health Committee; 2003;
  31. Davey K. Dental therapists in the Canadian north. J Can Dent Assoc. 1974;40:287–291
  32. Saskatchewan Dental Therapists Association Registrar: Report, 2007.
  33. General Dental Council. Annual Report, 2005. London, England; 2006.
  34. Education and Training of Personal Auxiliary to Dentistry. London, United Kingdom: The Nuffield Foundation; 1993;
  35. British Association of Dental Therapists Web site. Available at: http://www.badt.org.uk. Accessed January 11, 2007.
  36. Ambrose ER, Hord AB, Simpson WJA. Quality evaluation of specific dental services provided by Saskatchewan dental plan: final report. Regina, Saskatchewan: 1976.
  37. Crawford PR, Holmes, BW. An Assessment and Evaluation of Dental Treatment in the Baffin Region. a Report to the Medical Services Branch of National Health and Welfare. January 25, 1989.
  38. Trueblood RG. A Quality Evaluation of Specific Dental Services Provided by Canadian Dental Therapists. Medical Services Branch, Epidemiology and Community Health Specialties, Health and Welfare Canada; undated.
  39. Trueblood RG. An Analytical Model for Assessing the Costs and Benefits of Training and Utilizing Auxiliary Health Personnel with Application to the Canadian Dental Therapy Program. Montreal, Quebec, Canada: Department of Health Technology, Concordia University; 1992;
  40. Bradlaw R, Douglas THT, Roper-Hall HT, et al. Report of United Kingdom mission on New Zealand School Dental Service. NZ Dent J. 1951;47(228):62–78
  41. Friedman JW. The New Zealand School Dental Service: a lesson in radical conservatism. J Am Dent Assoc. 1972;85:609–617
  42. Redig D, Dewhirst F, Nevit G, et al. Delivery of dental services in New Zealand and California. S Calif Dent Assoc. 1973;41:318–321
  43. Roder DM. The effect of treatment provided by dentists and school dental therapists in the South Australian School Dental Service. Aust Dent J. 1973;18:311–319
  44. Roder DM. The effect of treatment provided by dentists and school dental therapists in the South Australian school dental service. The second report. Aust Dent J. 1976;21:147–152
  45. Roder DM. Diagnosis, treatment planning and referral by school dental therapists. Aust Dent J. 1974;19:242–249
  46. Riordan PJ, Espelid I, Tveit AB. Radiographic interpretation and treatment decisions among dental therapists and dentists in Western Australia. Community Dent Oral Epidemiol. 1991;19:268–271
  47. Gibson J, Ivancevich J, Donnelly J. Organizations: Behavior, Structure, Processes. Boston, Mass: McGraw-Hill/Irwin; 2002;
  48. Nash DA, Nagel RJ. Confronting oral health disparities among American Indian/Alaska Native Children: the pediatric oral health therapist. Am J Public Health. 2005;95:1325–1329
  49. American Dental Association. House of Delegates Proceedings. American Dental Association Annual Session. Chicago, Illinois, 2000.
  50. Memorandum to Robert E. Warren, Alaska Board of Dental Examiners from Paul R. Lyle, Sr. Attorney General, State of Alaska, Department of Law. Subject: State Licensure of Federal Dental Health Aides, 16 pages. Personal communication. Memorandum from Paul Lyle To Robert Warren dated September 8, 2005.
  51. Fiset L. A Report on Quality Assessment of Primary Care Provided by Dental Therapists to Alaska Natives. Submitted to the Alaska Native Tribal Health Consortium, September 30, 2005.
  52. Bolin KA. Assessment of treatment provided by dental health aide therapists in Alaska: a pilot study. J Am Dent Assoc. 2008;139:1530–1539
  53. Anchorage Daily News. Alaska lawsuit dropped. July 12, 2007.
  54. American Dental Association. ADA News. ADA reaches settlement in Alaska litigation. July 16, 2007.
  55. Anchorage Daily News. Dental therapist training program opens in Alaska. January 16, 2007.
  56. American Association of Public Health Dentistry. Resolution on the need for formal demonstration projects to improve access to preventive and therapeutic oral health services. 2006.
  57. American Public Health Association. Resolution on dental therapists in Alaska. 2006.
  58. To'olo G, Nash DA, Mathu-Muju KR, et al. Pediatric dentists’ knowledge and opinions about pediatric oral health therapists. Submitted to Pediatr Dent. July, 2009. In press.
  59. Lobene R. The Forsyth Experiment: an Alternative System for Dental Care. Cambridge, Mass: Harvard University Press; 1979;
  60. Sisty NL, Henderson WG, Paule CL, Martin JF. Evaluation of student performance in the four-year study of expanded functions for dental hygienists at the University of Iowa. J Am Dent Assoc. 1978;97:613–627
  61. Nash DA. Expanding dental hygiene to include dental therapy: improving access to care for children. J Dent Hyg. 2009;84:36–44
  62. Nowak AJ, Casamassimo PS. The dental home. A primary care oral health concept. J Am Dent Assoc. 2002;133:93–98
  63. American Academy of Pediatric Dentistry. Definition of the dental home. Pediatr Dent. 2008;28(suppl):10
  64. New Zealand Ministry of Health Toolkit: oral health. Available at: http://www.newhealh.govt.nz/toolkits/oralhealth. Accessed March 1, 2007.
  65. Teusner DN, Spencer AF. Dental Therapist Labour Force, Australia. 2003;Canberra, Australia: 2003. AIHW Dental Statistics and Research Series No. 29
  66. American Academy of Pediatrics. Available at: http://www.aap.org. Accessed July 7, 2009.
  67. Facts about family medicine. American Academy of Family Practitioners; 2008. Available at: http://www.aafp.org/online/en/home/aboutus/specialty/facts.html. Accessed July 7, 2009.
  68. American Academy of Pediatrics. Recommendations for preventive practice health care. Pediatrics. 2000;105:626
  69. American Academy of Pediatrics. Recommendations for preventive pediatric health care. Available at: http://www.brightfutures.aap.org. Accessed July 7, 2009.
  70. Phillips RL, Basemore AW, Dodoo MS, et al. Family physicians in the child health care workforce: opportunities for collaboration in improving the health of children. Pediatrics. 2006;118:1200–1206
  71. Center for Health Services Research and Policy . The Effects of State Dental Practice Laws Allowing Alternative Models of Preventive Oral Health Care Delivery to Low Income Children. Washington, DC: Center for Health Services Research and Policy, School of Public Health and Health Services, George Washington University Medical Center; 2003;
  72. Medical Group Management Association Web site. Available at: http://www.mgma.com. Accessed July 7, 2009.
  73. Cantrell C. Physicians’ Role in Children's Oral Health. Portland, Me: National Academy for State Health Policy. Cited by: Gehshan S, Snyder A. Why public policy matters in improving access to dental care. Dent Clin N Am. 2009;53:573–589

PII: S1876-2859(09)00249-6

doi: 10.1016/j.acap.2009.08.005

Academic Pediatrics
Volume 9, Issue 6 , Pages 446-451 , November 2009

Article Tools