Freshly minted dental therapists aid rural towns

The U is one of the first schools in the state to offer dental therapy.

Allison Kronberg

The University of Minnesota was among the first in the country to educate dental therapists, and it continues to graduate more of the new professionals every year.

Similar to nurse practitioners in hospitals, dental therapists help disperse the workload of a dental team. The University’s program began in 2009 after the state Legislature passed a law approving their certification.

Pew Charitable Trusts published a case study earlier this month on the first dental therapist employed by a private practice clinic in rural Minnesota, who was a graduate of the University’s first class of dental therapists in 2011.

The study found employing a dental therapist led the Montevideo, Minn., clinic, Main Street Dental Care, to a 38 percent increase in new patients — particularly of patients on Medicaid — and nearly $24,000 more in profits.

“There is a dental access problem statewide, especially for patients who are enrolled in Medicaid or who cannot otherwise afford dental services,” said Mark Schoenbaum, director of the Office of Rural Health and Primary Care for the Minnesota Department of Health. “The problem is often more pronounced in rural areas, where dentists are often spread more widely apart and patients must travel farther to secure care.”

The idea of a dental therapist isn’t new, he said. Dental therapists have practiced in more than 50 countries worldwide.

Karl Self, Division of Dental Therapy director at the University, said dental therapists are educated on a set of skills designated by the Minnesota Board of Dentistry. Working as a team in health care can help cut costs and make a clinic more efficient, Self said.

At the School of Dentistry, dental therapists learn alongside dentists and dental hygienists to reinforce this team care and prepare them for jobs. Dental therapists also have the opportunity to work with employers in private practices, large group practices, community clinics and mobile dental vehicles.

So far, the University’s program has graduated about two dozen dental therapists. After completing 2,000 hours of practice and a certification examination, the students are qualified to enter the workforce.

The Minnesota Department of Health presented a report to the state Legislature earlier this year on the impact of dental therapists over the past five years. Some conclusions included that they are practicing safely with high satisfaction and have improved low-income patient access statewide.

At Main Street Dental Care, dental assistant Melissa Jerve said their dental therapist, University graduate Brandi Tweeter, helps most with dental restoration procedures, like preparing cavities and placing temporary crowns.

While both dental hygienists and dental therapists must operate under supervision of a dentist, the positions are different because the hygienists focus on preventative care, while the therapists focus on restorative dental care, said Minnesota Board of Dentistry Executive Director Marshall Shragg.

But Self said the evolution of the dental therapist profession is comparable to dental hygienists. After the first program for dental hygiene began in the early 1900s, he said, it took decades for dental hygiene programs to gain recognition, and it wasn’t until the 1970s that dental hygienists were widespread across the country. Now, it’s rare to see dentists practice without one.

“I think the more people who see how well it works and the more it can serve these populations, the more attractive it will become across the country,” Tweeter said.

Tweeter said she learned about the opportunity to become a dental therapist from a friend she was practicing with at the clinic as a dental assistant.

Although the number of employers is growing with the rate of graduates, Self said it will require more research and education for more students to become aware of this new career.

“Nobody graduates from high school with their counselor saying, ‘You should be a dental therapist,’” Self said.

In order for more employers and more states to recognize the potential of dental therapists, he said, more research and education of their potential should be published.

This year, Maine became the second state to enact legislation approving the certification of dental therapists.

“[Minnesota] government and others will continue to evaluate the impacts of dental therapists as their numbers increase in the coming years,” Schoenbaum said, “and I expect other states will continue to watch what happens here.”