As a dentist at the Seattle Indian Health Board, I have seen far too many kids and adults experiencing dental pain and struggling to find the care they need because of severe dental provider shortages.
It doesn’t have to be this way. Right now, dental therapy is an evidence-based solution that is already working for several tribes in Washington and 12 other states across the country, and it should be allowed statewide. Dental therapists are care providers who expand the dental workforce and are often compared to physician assistants in medicine. They can provide many commonly needed non-complex dental services, such as checkups, fillings and simple extractions, freeing dentists to do more complex work and serve patients most in need.
The 2017 Washington law that authorized dental therapists to practice on tribal lands was a great step toward recognizing the tribal sovereign right to provide health care to their citizens. But that law specifically excludes urban Indian programs like Seattle Indian Health Board, although more than 78% of American Indians/Alaska Natives (AI/AN) live off of tribal lands and more than two-thirds of our patient base is from those communities.
Earlier this year, I was invited to serve on the Washington Dental Therapy Task Force, created by the Legislature, to examine how dental therapists could expand access to oral health care statewide. While it is true that American Indians and Alaska Natives suffer disproportionate oral health outcomes, we are not alone. Children living in low-income homes and children of color, specifically Black and Hispanic children, suffer disproportionately worse oral health outcomes than their affluent white peers. Access to oral health care is also out of reach for many seniors, rural residents, low-income families, people of color and patients who have coverage through Medicaid or are uninsured.
Task force members collectively spent hundreds of hours this summer and fall presenting and carefully reviewing evidence, asking and answering relevant questions, and engaging in hard and honest conversations centered on what is working in tribal communities in Washington and across the country.
One of the things that stood out most to me was the overwhelming agreement from reports, data and testimony from dentists and dental therapists in Washington Tribal clinics, supporting the effectiveness and safety of dental therapists. Dental therapists are a tremendous asset to the communities they serve. In Alaska, where dental therapists have been practicing the longest not only increased the number of patients seen, lowered wait times and improved travel times, but also improved community oral health and increased workforce diversity.
The results of this task force change the conversation about the pressing need for state legislative action this coming session. The task force included proponents, opponents and those neutral on past legislation, and had broad representation from communities with less access to dental care, dental and health care professional associations, oral health care providers, legislators, UW School of Dentistry and the Dental Quality Assurance Commission.
The final report shows that most members clearly favored the policies to expand dental therapy statewide that were supported by evidence of safety, effectiveness and ability to best serve those Washingtonians in need of care. The report reflects a huge investment of time and resources from stakeholders that gives legislators a better tool to guide them in the upcoming legislative session on crafting smart policy and better evidence to counter misinformation that has stymied action on this issue for more than 10 years.
I personally urge Seattle’s legislative delegation to act now.