Arizona governor Doug Ducey signed HB2235 into law on May 16, creating the licensing and regulatory structure to allow dental therapists to practice in the state. The law is the first of its kind in the Southwest and considered the most expansive of any state, according to the Dental Care for Arizona Coalition, supported by legislators on both sides of the political aisle.
“Dental therapists are a proven workforce that will increase affordable care options without creating new, burdensome regulations,” said state senator Nancy Barto, the bill’s original sponsor. “We worked hard to bring all stakeholders to the table, and the result is a bill that serves as model legislation for the rest of the country.”
“This law will create new, high-quality jobs while increasing access to safe, quality, and affordable oral healthcare to hundreds of thousands of Arizonans who lack access today,” said state representative Pamela Powers Hannley, who advocated its passage. “Preventing dental disease is critical to healthy populations and a healthy economy.”
Alaska and Minnesota have authorized the practice of dental therapy, while Oregon and Washington have authorized its practice on tribal lands. Maine and Vermont have passed authorizing legislation and are now developing the educational programs to train dental therapists.
“Having dental therapists as an option in Arizona will help meet the need in underserved populations, both rural and urban. They will help create healthy communities and a healthy workforce,” said state senator Juan Mendez, co-chair of the Arizona Latino Caucus, who also noted that the Latino and Native American populations lack access to care at higher rates than others in the state.
The legislation mandates a narrow scope of practice for dental therapists, working under indirect supervision and under a collaborative agreement with a dentist after completing its rigorous degree requirements. Schooling includes three academic years of study to cover about 80 procedures. Dental therapists in Arizona will be authorized to perform:
- Oral evaluations and diagnosis
- Image capture/x-rays
- Preventive services such as dental sealants and fluoride varnish
- Dental prophylaxis
- Prefabricated stainless steel crowns
- Extractions of primary teeth
- Extractions of badly diseased and highly mobile permanent teeth
In practice, the coalition reports, training takes less time and is less expensive than a four-tear dental school, so salaries will be lower than dentist salaries for a more cost-effective way for practices to serve more patients including those on Medicaid.
“The dental therapy model requires that these practitioners be as highly skilled in their limited scope of practice as dentists are. They will take the same clinical exams required for licensure that our dentists take for the procedures within their scope of practice,” said Deb Kappes, RDH, MPH, vice president of the Arizona Dental Hygienists Association.
“They will be trained in programs accredited by the same entity that accredits our dental schools in Arizona and across the nation,” Kappes said. “This is an innovative, cost-effective, free-market solution to the oral health crisis that exists in rural and underserved communities across our great state.”