Momentum increases in states to expand dental workforce

Wendell Potter
3 min readFeb 26, 2018


With growing momentum to allow midlevel professionals — called dental therapists — to practice in the United States, a tipping point could be reached this year that increases the likelihood they’ll soon be able to treat patients in every state.

Dental therapists have been practicing for almost 100 years around the world, starting in New Zealand. They are now serving patients in more than 50 countries with the U.S. being the most recent.

For more than 125 million Americans, basic dental care is out of reach. But there’s a solution that can help: dental therapy.

Alaska in 2004 became the first state in which dental therapists could practice. Five years later, Minnesota became the first state in the lower 48 to authorize their use. Maine and Vermont have since followed suit. Dental therapists are also now practicing in Native American communities in Oregon and Washington.

More states than ever before are now actively exploring authorizing dental therapy. The bipartisan support dental therapy now enjoys is reflected by the fact that some of them are controlled by Republican lawmakers while others are controlled by Democrats. The list currently includes Arizona, Florida, Hawaii, Kansas, Maryland, Massachusetts, Michigan, New Mexico, North Dakota, Ohio and Wisconsin.

The reason for the keen interest in dental therapy is the growing awareness that an ever-increasing number of Americans are not getting the oral health care they need. More than 125 million Americans lack dental benefits, and, according to the U.S. Department of Health and Human Services, more than 60 million now live in “dental deserts,” which are officially designated areas where few if any dentists practice.

More and more lawmakers on both sides of the political aisle are in agreement that dental therapists can be a game changer for their constituents, many of whom go years without stepping foot in a dental office.

Similar to other midlevel professionals, like nurse practitioners and physician assistants, dental therapists have a limited scope of practice. Working as part of a dentist-led team, they provide education and preventive care as well as uncomplicated extractions and fillings. Patients requiring care beyond a dental therapist’s scope of practice are referred immediately to a dentist.

Most dental therapists practice under the general supervision of a dentist, meaning they do not have to work in the same physical office as their supervisor. Many of the dental therapists now practicing in the United States travel every week to schools and clinics in communities within the more than 5,000 dental deserts, in both rural and urban areas.

Massachusetts could be one of the next states to authorize the use of dental therapists. More than three-fourths of the members of the Massachusetts Senate have signed on as co-sponsors of Senate Bill 1169, which was introduced by Democrat Sen. Harriette Chandler, President of the Senate, co-chair of the legislature’s Prevention for Health Caucus and a longtime advocate of dental therapists. Among the bill’s co-sponsors is Republican Bruce Tarr, Senate Minority Leader. The House version of the bill also has bi-partisan support.

When asked why she became a champion of dental therapists, Sen. Chandler said: “It cannot be stated often enough: too many people are deprived of dental care.”

She said that her legislation is structured to “give midlevel practitioners the freedom to work flexibly and efficiently, to ensure that the best care is delivered to the greatest amount of people — especially those who are still tragically underserved.

“Our most vulnerable populations — children, minorities, the elderly, and the disabled — are all hurt the worst. We have a coalition that agrees that this legislation is a solution — and after nearly four years of debate, it’s time for this solution to become law.”

Lawmakers are expected to vote on the legislation next month.



Wendell Potter

Wendell Potter is a former health insurance executive, author of Deadly Spin and Nation on the Take, and founder of, a new journalism organization.