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OREGON — A coalition of Oregon health and dental care organizations, educators, Tribes and tribal organizations are supporting legislation to be introduced at the start of the 2020 Oregon legislative session that would make basic dental care available to more Oregonians.

The legislation, Senate Bill 1549, would expand dental care access by authorizing the licensing of dental therapists —  primary dental care professionals who provide preventive and routine care under the supervision of a dentist. This healthcare delivery model has been used worldwide for over a century, and was introduced in the United States by Alaska Natives 15 years ago. Alaska has since seen both increased access and improved oral health in communities served by dental therapists. Since then, 11 other states have authorized dental therapy in some or all settings.

“Every Oregonian deserves access to timely, affordable and high-quality oral health care,” said Dr. Miranda Davis, a dentist and director of the Native Dental Therapy Initiative of the Northwest Portland Area Indian Health Board. “Without that care, many Oregonians suffer from serious dental disease, and this can also harm their overall health and quality of life.”

Willamette Dental Group is among a number of groups supporting the legislation.

“This legislation would allow Oregon to evolve its dental workforce and better meet the needs of people around the state, and to pursue innovative solutions to address complex issues,” said Dr. Eugene C. Skourtes, President and CEO of Willamette Dental Group. “Innovation is a part of our organization's core values and we support licensing dental therapists and incorporating them as part of our team-based approach to care delivery.”

Dentist shortage

Over 1 million of Oregon's roughly 4 million residents live in areas that have a shortage of dentists. All but four counties in Oregon are considered to have a shortage of dentists. And 26 primary care service areas in rural Oregon have no full-time dentist, according to a 2019 report from the Oregon Office of Rural Health.

This lack of access, and dental problems that result, are more pronounced in low-income, rural and non-white communities. In American Indian/Alaska Native communities, 43.2 percent of 3- to 5-year-olds have untreated tooth decay, about four times the rate for white children. Hispanic and Black children have almost twice the rate of untreated decay as white children. Meanwhile, only 27 percent of adults and 44 percent of children covered by Medicaid — which covers healthcare for low-income families —  had a dental visit for any reason in 2015, the most recent year for which figures are available.

What all of this means is that, in many places, a preventable cavity can turn into to a trip to a hospital emergency room —  a highly inefficient use of healthcare resources that doesn't solve the underlying problem. There are many other health and socioeconomic impacts, too. Abundant evidence shows that oral health is critical to overall health: Gum disease and other oral health conditions are linked to heart disease, diabetes and some cancers. Dental pain impacts nutrition, sleep, learning and job performance. And having a healthy smile improves one’s ability to gain and maintain employment.

Pilot program

Dental therapists are already practicing in a limited capacity in Oregon. A pilot program of the Oregon Health Authority — called the Oregon Tribes Dental Health Aide Therapist Pilot Project — authorizes dental therapists to serve three Native American tribal communities: the Confederated Tribes of Coos, Lower Umpqua and Siuslaw Indians (CTCLUSI), the Coquille Indian Tribe and the Native American Rehabilitation Association in the Portland area.

“It means so much to me to be able to do this work — to have a meaningful career that supports my community while also providing a service that changes people's lives,” said Naomi Petrie, dental therapist for CTCLUSI.

Another dental therapy pilot sponsored by Willamette Dental Group and Pacific University is set to start training students in February. “We want to build a new workforce in Oregon that is responsive to our most pressing oral health care needs, create good jobs and get care to the areas where it is needed most,” said Amy Coplen, RDH, EPDH, MS, who is program director of the School of Dental Hygiene Studies at Pacific University.

Oregon Sen. Laurie Monnes Anderson, D-Gresham, will introduce Senate Bill 1549.

“It’s past time to turn the tide on oral health disparities in our state,” Monnes Anderson said. “I’m excited to work with my colleagues to expand access to dental care with dental therapists.”

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