Dental therapists likely to deliver poor care

Florida’s sunshine, lack of state taxes and wealthy seniors have created a glut of dentists on every street corner.

It is a fallacy that there is a shortage of dentists. Graduates of Florida’s three dental schools have a difficult time finding positions. That is why corporate dentistry has flourished in the state, with a glut of dental graduates willing to take lower-paying jobs.

The supply of dentists is proportionate to demand: if there is a wealthy populace, there will be an ample supply of dentists. The “underserved” areas are either too rural to support a dentist’s practice or the residents are financially not capable of paying the high fees.

The only “shortage” of dental care is for individuals who have no money — the poorest who qualify for free dental care through Medicaid.

Source: Dental therapists likely to deliver poor care / The Gainesville Sun

4 Responses

  • What does the glut of dentists have to do with the allegations that therapists will provide poor care?
    These two things have nothing to do with each other.

  • The disclaimer in this article that it is an opinion piece should be in all CAPS, because this dentist has no clue and no evidence to support his theories. Give us the citations, Doctor. Or do you even know what PubMed is or how to use it.
    Your solution to the problem of getting poor kids treated is to raise Medicaid, a hopelessly dead horse that organized dentistry continues to beat. Why? Because in your own article you claim that states that raise Medicaid fees to high levels encourage DENTISTS to move in to the state and then fraud and poor care results. So shouldn’t you be complaining about DENTISTS providing poor care when Medicaid fees are raised?
    Your arguments are cognitively dissonant and have no evidence to support them. In case you forget, the ADA and Alaska Dental Society lost their federal case claiming therapists are illegal and create a two-tiered system:” those organizations fined over $1M for their specious lawsuit claims.

    BTW, I am an instructor in a CODA accredited dental therapy program, and have seen first hand the work these therapists do. No one has been hurt by them in the past 11 years that I have been a faculty in the program. Peer reviewed publications are showing that.

  • According to Dr. Bernstein,  many young dentists, old dentists and those in-between are either care nothing of quality, or that they are so debilitated that they should not be allowed to practice in Florida. 

    If dentistry in Florida is a bad as Dr. Bernstein claims that it is, he has an ethical obligation to report it to the state board of dentistry. If the board does not take action, then has an obligation to take his complaint to Governor DeSantis. Surely, at least The Gainsville Sun should investigate his claim, which has grave implications for public health and a waste of state and federal treasure.

    As for dental therapists, there is a century of knowledge and study, regarding to how well they have performed “basic dental care.” There is not a shred of evidence to back up Dr. Bernstein’s claim, that they “might” provide sub-standard care, especially for the dentally under served in Florida.

    The facts speak for themselves, that studies have repeatedly demonstrated that therapists provide safe, competent and appropriate dental treatment. The Alaska dental therapist, upon which the proposed FL legislation is fashioned, has been a success since 2005. The model, upon which it is based, has been successful, in New Zealand, and subsequently in approximately 50 countries, since 1922.

    While Dr. Bernstein might not like them, patients have loved them and that, where they are employed, they have taken a bite out of waiting times and helped to improve access to dental care. I wonder if he would turn away a Paramedic, or an EMT, or any number of physician extenders, because they are not MDs.

    Demand for dental care is not all that matters. Bernstein overlooks the great and costly impact of unmet dental needs. Lost time in schools, jobs and the impact of poor oral health on daily living, as well as the human body, as a whole,. What we know now, is that the impact of disease in the mouth is no less important than an infection elsewhere in the body. 

    It would be interesting, indeed, if Dr. Bernstein would back up his claims with evidence.

  • I agree that Dr Bernstein’s opinions are not backed up by evidence, and cannot be because all evidence tells the opposite story regarding dental therapist’s safety and competence.
    But I like the call for evidence.
    The evidence about Alaska is that it did not serve as the model for FL’s bill to license DTs. Alaska nor New Zealand has served as the model for any dental therapist licensing bill anywhere in the US. The model that serves as the basis of dental public health successes in AK and NZ and most other countries with decades of DTs in their workforce, has been completely avoided by every legislative effort ever submitted to a state legislature seeking to license dental therapists.
    I won’t argue that the DT training level in this year’s FL DT Licensing Bill is similar in nature to that of AK. And it is similar in nature to many countries with DTs. But the FL bill is not similar to MN, or any other state’s DT licensing law that has passed. (Exception is MI, I think.) But the level of training is not what makes or breaks the impact on dental public health for the communities and populations most in need.
    I get the impression that all of this is above and beyond Dr Berstein’s familiarity with the subject.

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