Readers' Letters

Congratulations to the Portland Tribune on a good article (Oregon won’t smile on dental therapists, July 17). I was interviewed for the article and want to clarify a few things about my remarks.

Dentists have had a decline in income from slightly more than $200,000 per year if self-employed to under $200,000 on a gross collection of more than $400,000. They never netted $450,000.

The demand for dental therapists in Minnesota is limited based upon several factors: the legislative requirement to work in indigent area dental practices, the newness of the profession and the fact that they are not needed in every area.

Dental therapists are for dental caries (tooth decay) what the dental hygienist is for periodontal disease and other chronic disease management.

The dental hygiene model works very well in dental therapy and is in fact the de facto model in the other dental therapy program in Minnesota, which only selects dental hygienists.

The economic value of a dental therapist in a dental practice is an emerging area of investigation. I believe that only a dental therapy profession that cares for patients with dental disease under the aegis of an existing dental practice can ever (and should ever) be successful. That is because only a dentist can provide the full range of complex series needed to treat oral diseases.

The dental therapist is meant to be a member of the oral health care team headed by a dentist.

So how is dental therapy “about the money”? Imagine you had a wonderful automobile for sale, but it cost too much for everyone to afford. You would create a focused approach (like Henry Ford did) to provide the ability for everyone to have an automobile.

With disease rates up for untreated dental disease and the No. 1 barrier cost (what patients and the public are able to pay for those services), being able to reduce the cost to a practice to provide a unit of that service would seem to be a good idea. Thus, in a high disease area, a dentist could utilize a dental therapist, as a new oral health professional, and provide care to patients (such as public pay patients and those with limited income) who they would otherwise truly be unable to see in a viable business model.

Thanks again to the Portland Tribune for raising public awareness on the barriers we must overcome to improve oral health.

Leon Assael


State needs access to quality dental care

Your story (Oregon won’t smile on dental therapists, July 17) highlighted the need for action in improving access to quality dental care in Oregon. As president of the American Dental Hygienists Association and a proud Oregonian, I fully support increased access to care through the utilization of dental hygienists and mid-level providers to deliver essential dental care services to the public.

As a registered dental hygienist with an expanded practice permit, which allows a dental hygienist to initiate services independently to underserved populations, I have seen firsthand the need for access. Oregon is one of 37 states allowing dental hygienists to independently initiate patient care in at least one setting outside a private dental office.

The ADHA is committed to developing educated, dedicated providers who deliver safe, quality oral health care to those in need. More than 185,000 dental hygienists are licensed in the U.S. — utilizing this workforce in a manner that allows us to work with flexibility will help many gain access to care.

Lack of access to dental care is a serious problem in Oregon. Mid-level providers in Minnesota are already proving underserved populations can be served safely and effectively by these mid-level providers. Oregon has the legislative authority to expand access to oral healthcare utilizing pilot projects. The time is now.

We must remember that everyone, including the most underserved in our communities, deserves access to affordable oral health services. The public will benefit most from a hygiene-based mid-level provider that can deliver both the preventive scope of a dental hygienist and the restorative scope of a dental therapist.

Kelli Swanson Jaecks, MA, RDH

President, American Dental Hygienists’ Association


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