In exam rooms across the country, patients are regularly examined and treated for basic ails by physicianâÄôs assistants and nurse practitioners. In a few years, the same could be true in the dental field. A new mid-level dental position, called the oral health practitioner, was created by legislation passed last spring, and students will begin classes this fall at the University of Minnesota and Metropolitan State University. âÄúIt will give us another tool, another option available to be able to address the significant unmet need in oral health in Minnesota,âÄù said Sen. Ann Lynch, DFL-Rochester, author of the legislation. Last sessionâÄôs bill created a work group that met from August through December of last year. The Legislature will make a final decision on the positionâÄôs licensure and scope of practice this spring, based on recommendations reported by the work group last week. Among the recommendations for the new position would be that the OHP would work under a collaborative agreement with a licensed dentist, and would work primarily in areas of undeserved and uninsured patients. âÄúWhatâÄôs being added is the everyday kind of restorative work, more straight forward extractions, fillings,âÄù said Thomas Cook , executive assistant to the president at Metropolitan State University. âÄúIt allows each practitioner to work at the top of their license.âÄù Other countries, such as New Zealand and Britain, already have a similar position in their health care system. Lynch said her legislation isnâÄôt about benefiting the dental profession, which some see as behind the times in creating a mid-level position. âÄúThe legislation being put forward is for all the people whose voices are not in the room, all the people who donâÄôt currently have access to oral health care,âÄù she said. Hennepin County Medical Center reports about 20,000 oral-health related emergency visits each year, she said. A report made by the work group shows about one third of Minnesotans do not have dental insurance. These people, the ones Lynch is concerned about, âÄúthey do nothing,âÄù she said. âÄúThey wait, and they end up in our emergency rooms.âÄù Minnesota would be the first state to create educational programs for a mid-level dental position. Alaska currently licenses a limited number of practitioners to work on reservations, but they are educated overseas. The University and Metro State programs each look to admit between 10 and 15 students this fall, once the scope of practice bill is passed in the Legislature, defining the exact parameters of the position. Metropolitan State and Normandale Community College will offer a Master of Science Oral Health Care Practitioner Program. Admitted students will be required to already have their bachelorâÄôs degree and be a currently licensed dental hygienist, Cook said. The students will receive hands-on training in the existing dental hygiene facilities at Normandale, said Dr. Colleen Brickle, interim dean of health sciences at Normandale , and the degrees will be issued through Metro State, which is a four-year university. The program will take about two years and a summer, or 44 credit hours, to complete, Brickle said. MNSCU tuition is expected to be around $350 per credit. The University Dental School joined the mix in February as LynchâÄôs original legislation began circulating. As the stateâÄôs only accredited dental school, âÄúit was on us to participate in shaping this program,âÄù said Patrick Lloyd, dean of the School of Dentistry. The University will offer two degrees in dental therapy, a bachelorâÄôs degree and a masterâÄôs, he said. The bachelorâÄôs program will require 120 credits and the masterâÄôs will require 72 to graduate. The UniversityâÄôs current proposed tuition for the program is $3,795 per semester for in-state students, or $303 per credit, if they donâÄôt take a full semester course-load. Additional fees around $600 will cover equipment and supplies. Because the salary of an OHP would be lower than that of a dentist, despite performing procedures currently handled by the dentist, âÄúit would be factored into the equation for reducing the cost of care,âÄù Lloyd said. In order to develop the curriculum, Lloyd and other dental faculty traveled around the world and visited educational programs in Britain, Canada and New Zealand to study existing programs. The U’s curriculum is subject to approval by the Board of Regents this spring. The University has also requested $834,000 in financial support to assist with hiring additional faculty and facilities renovation. If the funding request is denied, the University is “not going to be able to advance the program,” Lloyd said. Christine Blue, the UniversityâÄôs director of the division of dental hygiene, was one of those faculty, and she said the models in other countries wonâÄôt be perfectly adaptable here, but many aspects will be. ItâÄôs still unknown how much of the dental therapy program will align with the current hygiene track and how much will fall to the dental side, she said, and it will depend on the final parameters set by the Legislature. Critics of the new position are concerned practitioners with less training than licensed dentists will create a second-standard of care, but Blue said because the OHP students will be trained side-by-side with the dental students, âÄúwe really shouldnâÄôt be able to tell a difference between these students in the student body.âÄù The first crop of oral health practitioners will graduate in summer 2011 and Cook, of Metro State, believes they will all find jobs immediately. âÄúThe demand for these graduates will outstrip the supply for quite a while,âÄù he said. âÄúThey will be snapped up by clinics that serve underserved populations.âÄù Lynch said she knows some dentists are opposed to the recommended scope of practice, and a challenging bill may be introduced this session. âÄúAll IâÄôm asking is that we focus on the need, and that we put this forward as a tool, an option available to address this very real need,âÄù she said, adding that dentists who arenâÄôt comfortable employing an OHP would not be required to do so. But Lynch said she believes similar objections were made when the nurse practitioner and physicianâÄôs assistant positions were created, âÄúand we know today that physicianâÄôs assistants are an integral and respected part of the medical practice,âÄù she said. âÄúI believe there will be a time in Minnesota and this country when the mid-level dental practitioner will share that same repute.âÄù — Emma L. Carew is a senior staff reporter.