Dental Health Aide Therapists Can Be Part of Much-Needed Solution to Dental Care for Rural Alaskans

ATLANTA — Dental health aide therapists may improve access to care for oral health where access to dentists is limited, according to a new study by researchers at RTI International and the School of Dentistry at the University of North Carolina at Chapel Hill.

Dental therapists, under the general supervision of dentists at regional offices, may perform cleanings, dental restorations and uncomplicated extractions.

"There is an acute shortage of dentists willing to practice in small, remote villages in Alaska." said Scott Wetterhall, M.D., senior program director of Health Security and Systems Research at RTI and the study's principal investigator. "Relying on a traditional itinerant care approach leaves people with limited access to emergency and preventive treatment, allows disease and associated pain to worsen and fosters expectations that dental care should be sought only when a person is in pain."

The study, published in the October issue of the American Journal of Public Health, surveyed 62 adults and more than 200 parents of children 6 to 17 years of age who had been treated during the previous year by a dental health aid therapist. The researchers asked them questions about their experiences and studied their clinical records.

The patients surveyed reported that they were very satisfied with the care they received from dental health aide therapists, and their satisfaction with this care did not differ from satisfaction with the care provided by other dental practitioners.

Village residents said that having a village-based dental health aide therapist improved access for dental emergencies.

The dental health aide therapists also educated village residents, particularly children, about the importance of preventive dental care.

"Our research showed that using a dental health aid therapist could be an important component of a broader program to address the crisis-of-care challenge posed by a growing shortage of dentists, particularly for sparsely populated areas," said Barri Burrus, senior community health psychologist at RTI and the article's co-lead author.

According to the research, the dental health aide therapist model minimizes impediments such as travel requirements and weather, and makes access to emergency and regularly scheduled restorative and preventive care a viable option.

"The dental health aide therapist model does not and was never intended to replace the services of licensed dentists," Burrus said. "The model's design specifies that dental health aide therapists operate under supervision of a licensed dentist, and even then allows only a relatively limited scope of practice. The licensed dentist must continue to play a key role in performing more complex and specialized procedures."

The researchers suggest the dental health aide therapist model is just one piece of the solution for improving dental care in rural and underserved groups.

"Other strategies, such as decreasing sugar consumption and fluoridating water safely, must also be encouraged," Burrus said.