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My Turn: This is the wrong way to increase access to dental care

Re “Let’s expand the dental team” (Monitor Opinion page, Feb. 16):

Like all dentists, I share the concern of Dr. Robert C. Keene about ensuring quality oral health care to all residents of New Hampshire. However, the introduction of yet another new dental provider is not the best way to attain that goal.

Less than a year ago, New Hampshire’s dentists, in conjunction with other stakeholders and New Hampshire legislators, worked to support efforts that are about to expand the role of dental hygienists in our state and bring a new, expanded function dental assistant to help close the coverage gap. These workforce changes, passed last year, hold great promise and need to be given time to make a difference. The new Senate bill mentioned by Keene is redundant and would do nothing to improve access to care in New Hampshire.

New Hampshire’s oral health system is ranked at the top among all states in the country. According to the Centers for Disease Control, New Hampshire is one of only five states in the country in which 75 percent of its adult population visited a dentist in the past year. According to the New Hampshire Department of Health and Human Services, children on Medicaid have better access to a dentist here than anywhere else in the country. While we are ahead of other states when it comes to the oral health of our population, we do not rest on that fact and continue to find ways to improve our oral health system, but this new legislation goes too far.

The model for this legislation is taken from two very large states with pockets of isolated communities – states that, frankly, do not bear much similarity to New Hampshire. And neither of those two states, Alaska and Minnesota, has the type of “dental hygiene practitioner” proposed in SB 193. The new practitioner proposed in SB 193 is nothing like nurse practitioners or physician assistants, which are at least master’s-degree-level professions. What appears to be proposed is a dental hygienist with a minimum of one year of additional training. This proposed new practitioner would be allowed to extract teeth without a medical degree or even a basic college degree.

Why is this new provider necessary for New Hampshire when we know that the best ways to increase access to oral health care are to promote public awareness, recruit new dentists to rural areas, improve transportation, increase fluoridation and financially sustain dental clinics? Recently, dentists all over New Hampshire worked through Give Kids a Smile to offer free care to thousands of their neighbors. They volunteer their time in clinics and donate hundreds of thousands of dollars in free care each year. Dentists are medically trained doctors who can spot things as serious as cancer and can provide immediate medical care if a patient has a seizure, heart attack or a medical emergency in a dental chair.

New Hampshire dentists are working together with the state and public health advocates to find better ways to increase the number of people who receive oral health care. We do not want to see New Hampshire reduced to a two-track oral health system, with medically trained dental care for those with insurance and “technicians” for those families with fewer resources. We fear that this bill may begin to lead us down that path. Every citizen has the right to quality dental care, regardless of their economic standing. We believe that every child and should see a dentist who is a doctor. SB 193 is not right for New Hampshire.

(Dr. Glenda Reynolds is president of the New Hampshire Dental Society.)

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