On the Front Lines of a Broken System
I met my future daughter in Operatory #10 at the Yukon-Kuskokwim Health Corporation clinic in Bethel, Alaska 16 years ago. She was 3-years-old, in foster care, and lying there in terrible pain. Her face was swollen from an abscessed tooth, her temperature was 104 degrees.
My heart went out to her. As a staff dentist at the clinic, I see many people in pain. My heart goes out to all of them, but I struggle the most when I see young children suffer and face serious health consequences from conditions that could have been prevented.
She had an infected tooth and could have died. And, she suffered horribly. Why? Because she couldn’t get dental care where she lived. Because of a dental care system that makes it almost impossible for some people to get care when they need it, in their own communities.
It is because of children like my daughter that I am on the front lines of trying to change how we provide dental care in this country.
One of the things I am most proud of is that I have helped establish dental therapists here in Alaska. In just 10 years, dental therapists have been able to expand dental care to 40,000 people here who couldn’t get that care before. They are so effective because they work with dentists as part of a team to bring dental care to communities that dentists can’t get to very often. They allow the dental team to treat more patients—in much the same way that nurse practitioners and physician assistants allow the medical care team to do the same.
I believe dental therapy can improve access to dental care across the United States. Unfortunately, my daughter’s story isn’t unique. I hear similar stories from people in every community I visit as I travel the country. While we all want our children to be healthy, millions of children and families across the United States struggle to get the dental care they need.
It is a serious crisis.
As a dentist, I have seen firsthand the devastation lack of access to care can result in. When people cannot get dental care, they suffer, miss work and school, and, like my daughter, are at risk for serious, sometimes life-threatening infections.
There are many reasons why people have difficulty getting dental care: they live in a rural area or Tribal community where dentists don’t practice; they have hourly wage jobs they can’t afford to leave to get care during office hours; they live in a city flush with dentists but none who will accept their Medicaid insurance; or the cost of care is simply more than they can afford.
Dental therapy is an innovation that could be widely adopted throughout the United States. Minnesota and Maine already allow dental therapists to practice, and many other states and Tribes are pushing for dental therapists in their communities. Efforts are underway in Kansas, Ohio, New Mexico, North Dakota, Oregon, Vermont and Washington.
Unfortunately, this common-sense, proven way of getting dental care to those who need it most faces an uphill battle because the American Dental Association (ADA) has fought against dental therapists every step of the way—even suing the bright young people we initially trained as dental therapists in Alaska. It’s a typical story of an entrenched, privileged interest group fighting against change, perhaps fighting to protect its turf, in the same way that doctors once opposed nurse practitioners, even though they couldn’t imagine functioning without them now.
As a dentist, I find the ADA’s opposition disappointing and shortsighted. The concerns raised by the ADA have no basis in fact. The evidence is clear, dental therapy is a safe, effective and appropriate way to address dental access issues.
As the mother of a child who suffered so horribly from lack of access to dental care, I find the ADA’s opposition reprehensible and borderline immoral.
As fate would have it, I was able to adopt my daughter 4 years after we met and now she is a healthy young woman who looks forward to visiting her dental therapist! As a mother, it is so clear to me that we all have the same goals and want the same things—healthy thriving children, families and communities.
Dental therapists have worked to help us achieve that in my community and they can work in yours.