The Wisconsin AGD needs your help in generating opposition to Senate Bill 89/Assembly Bill 81, which would allow for the licensure and practice of dental therapists in Wisconsin. We believe in increasing access to oral health care for Wisconsin residents with safe and effective policies which this legislation does not represent.
It is crucial that the Wisconsin AGD's opposition is heard by state legislators. Please take a moment to send a letter to your legislators urging them to oppose SB 89/AB 81 and to consider more effective methods of increasing access to oral health care.
URGENT: TAKE ACTION NOW
Among other reasons, the WI AGD opposes this legislation for the following:
- Dental Therapist Models Not Proven to Increase Access in Underserved Areas
- Advocates of dental therapy often point to Minnesota, the first state to authorize DT licensure, as an example of how this model has increased access to care in rural and underserved areas. However, the majority of DTs in Minnesota practice in the Minneapolis-Saint Paul metropolitan area which are not determined to be Health Professional Shortage Areas (HPSAs), or where there is no shortage of providers.
- SB 89/AB 81 authors state this legislation intends to increase access to oral health care. However, it does not require nor incentivize dental therapists to practice within areas or populations of need, which would likely lead them to similarly choose areas that make their practices economically viable, or areas that are not in need of more providers.
- Other states that have authorized dental therapist licensure typically include language in their legislation calling for dental therapists to serve a specified population of individuals: i.e. certain percentage of patients must be low-income or publicly insured, DT must work in a Federally Qualified Health Center, governmental or public health clinic, nursing facility, etc. Though these requirements are rarely overseen or accounted for due to their need for ample state resources and surveillance, Wisconsin’s bill does not even attempt to enforce similar rules.
- Education Requirements Not sufficient – Safety a Concern
- SB 89/AB 81 authorizes a licensed dental therapist to provide surgical and irreversible services under general supervision, which does not require a dentist to be present in the office or the premises during the time a procedure is being performed, nor does it require prior examination or diagnosis of the patient by a dentist. Some procedures would include: tooth reimplantation and stabilization, preparation and placement of direct restoration in primary and permanent teeth, and pulpotomies on primary teeth.
- To become a dental therapist in Wisconsin, just three years of postsecondary education with no prior background in dental hygiene is needed. The population this bill aims to serve (publicly insured, low-income, etc.) are among the most medically compromised with the greatest need of extensive care. Limited scope providers such as dental therapists would not adequately serve this need.
- Marquette University, who houses Wisconsin’s only dental school, is currently one of the few in opposition of SB 89/AB 81. The MU Dental School and Dean of the Dental School have expressed their lack of capacity to host a dental therapy program, and that they believe it would not complement their long-standing, current clinical model.
- Workforce Shortage
- Proponents of this bill argue that Wisconsin faces a dental workforce shortage. However, studies carried out by the ADA Health Policy Institute show that there is no shortage of providers in Wisconsin; instead, there is a maldistribution. Alternative solutions to providing access to care include dental student debt programs or increasing Medicaid reimbursement rates to incentivize current providers to serve in underserved areas.
The Senate Committee on Health and Human Services held a public hearing for SB 89 on August 21, 2019. A coalition of nearly 60 dental therapy advocate organizations appeared in support of the bill, with some offering public testimony. AB 81 has not yet been heard in the Assembly, but has been assigned to the Assembly Committee on Medicaid Reform and Oversight. Currently, only three organizations are in opposition including the Wisconsin AGD, the Wisconsin Dental Association and Marquette University.
For questions regarding the bill, you may contact AGD Advocacy staff at email@example.com
Lou Boryc, DDS, FAGD
President, WI AGD