My Turn: This is the wrong way to improve dental care
I am writing in response to several columns and letters published in the Monitor over the past few months concerning Senate Bill 193, which would implement a mid-level dental care provider (dental hygiene practitioner) in our state.
I appreciate the input from Mary Duquette, president-elect of the New Hampshire Dental Hygienists Association (“Let’s expand our ability to deliver dental care,” Monitor Forum, Nov. 8). She states that this mid-level provider is “already helping patients in Minnesota, Alaska and in 50 other countries.”
And that’s fantastic. But this is New Hampshire.
New Hampshire does not have remote areas of Native populations where physical access to the area is best accessed through air travel, such as in Alaska.
New Hampshire elects responsible and respectable members of our community to public office, such as Govs. Maggie Hassan and John Lynch, not a former professional wrestler such a Jesse “The Body” Ventura, who becomes a leading advocate for conspiracy theories behind 9/11, such as in Minnesota.
And, New Hampshire isn’t New Zealand, Australia or Malaysia. New Hampshire deals with our own problems in our own New Hampshire way. When outside influences, such as the president of the Minnesota Dental Therapy Association, start weighing in and pressuring our state legislators, the residents of New Hampshire should be startled and offended (“Misunderstanding dental therapists,” Monitor letter, Nov. 20).
As a dentist, I received eight years of post-high school education before I could interact with a patient on my own – eight years of developing critical thinking skills.
Dentistry is more than just filling holes in people’s teeth; it is treating the entire patient. It is understanding and responding to the possible side effects of the procedures we perform.
The mouth is the gateway to the rest of the body. Many systemic diseases manifest themselves through oral changes. The critical thinking skills I developed help me recognize these changes and take appropriate actions. In fact, many dentists receive training beyond dental school before opening up or joining practices.
Senate Bill 193 would require high school graduates to complete just three years of training before becoming a dental hygiene practitioner. The thought of an unsupervised 21-year-old being an integral part of a patient’s overall health care is alarming.
The president-elect of the New Hampshire Emergency Nurses Association recently wrote that “by expanding the dental team to allow another provider to be licensed, similar to nurse practitioners or physician assistants, patients would have better access to care at a more affordable cost” (“ER no place for dental issues,” Monitor letter, Nov. 27). However, a dental hygiene practitioner can in no way be compared with a nurse practitioner or a physician assistant. This typifies the quintessential apples and oranges argument.
Nurse practitioners need both a bachelor’s degree in nursing and a graduate degree. Most physician assistants also have their bachelor’s degree in addition to close to three years of training in their respective programs. Both undergo state licensing, continuing education and recertification.
Dental hygiene practitioners, after just three years of study (less than half the schooling a physician assistant or nurse practitioner receives), are performing irreversible procedures on patients. They are not ordering tests or assisting. They are performing things that cannot be undone. Is this what the residents of New Hampshire want?
A mid-level provider is not a magic wand that will solve the dental problems of New Hampshire residents. Dental disease is entirely preventable. This is where our focus should be. Having a dental hygiene practitioner will not magically make tooth decay disappear.
New Hampshire should focus on prevention and adequate fluoridation. Adding an additional, unsupervised and inexperienced member to our dental team is not New Hampshire’s answer.
Both proponents and opponents of dental hygiene practitioners make their arguments based on numbers and statistics, but with a patient’s long-term well-being and health in mind, I would strongly urge SB 193 be defeated.
(Dr. Charles Thomas is president of the Greater Concord Dental Society.)