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DR. ZACK STUDSTILL EXECUTIVE DIRECTOR ALABAMA DENTAL ASSOCIATION

MID-LEVEL PROVIDERS IN DENTISTRY “TO BE OR NOT TO BE” THAT IS NOT THE QUESTION THE QUESTION IS “WHICH ONE WILL BE LEFT STANDING”. DR. ZACK STUDSTILL EXECUTIVE DIRECTOR ALABAMA DENTAL ASSOCIATION. MID-LEVEL DENTAL PROVIDER MODELS. NEW ZEALAND DENTAL NURSE/THERAPIST

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DR. ZACK STUDSTILL EXECUTIVE DIRECTOR ALABAMA DENTAL ASSOCIATION

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  1. MID-LEVEL PROVIDERS IN DENTISTRY “TO BE OR NOT TO BE” THAT IS NOT THE QUESTIONTHE QUESTION IS “WHICH ONE WILL BE LEFT STANDING” DR. ZACK STUDSTILL EXECUTIVE DIRECTOR ALABAMA DENTAL ASSOCIATION

  2. MID-LEVEL DENTAL PROVIDERMODELS NEW ZEALAND DENTAL NURSE/THERAPIST ALASKA DENTAL HEALTH AIDE ADVANCED DENTAL HYGIENE PRACTITIONER COMMUNITY DENTAL HEALTH COORDINATOR MINNESOTA DENTAL THERAPISTS EXPANDED FUNCTION DENTAL ASSISTANT

  3. NEW ZEALAND DENTAL NURSE/THERAPIST New Zealand Dental Therapist • Program was initiated in 1921-treat children • Educated in a two year program • Perform oral examinations • Develop treatment plans • Provide preventive services • Administer local anesthesia • Prepare and restore primary and permanent teeth • Extract primary teeth. • Work under the general supervision of a Ministry of Health dentist.

  4. ALASKA DENTAL HEALTH AIDE THERAPISTDHAT Alaska Dental Health Aide Therapist • Deployed by the Alaska Native Tribal Health Consortium to remote Alaska Tribal Villages • Scope of practice includes preventive services • Basic dental restorative services focused on children’s dental health needs • Tooth extractions • Use of local anesthesia • Training is a two-year program following high school

  5. ADVANCED DENTAL HYGIENE PRACTITIONER Advanced Dental Hygiene Practitioner • Proposed by the American Dental Hygienists’ Association • Scope of practice would include traditional dental hygiene services • Basic dental restorative services • Use of local anesthesia • Tooth extractions • Administration, policy, and research • Suggested training is a one- or two-year post- bachelor’s masters degree program

  6. COMMUNITY DENTAL HEALTH COORDINATORCDHC Community Dental Health Coordinator • Proposed by the American Dental Association Now being piloted • Scope of practice is limited to preventive, palliative care and care coordination services • Pilot training program currently for high school graduates to learn both community health worker skills and preventive, palliative dental procedures in an 18 month program

  7. MINNESOTA DENTAL THERAPISTS Minnesota Dental Therapist • Now being implemented • Scope of practice includes preventive services • Basic dental restorative services focused on children’s needs • Tooth extractions • Training options include a bachelor’s masters degree or a two-year post-bachelor’s degree program.

  8. EXPANDED FUNCTION DENTAL ASSISTANT Expanded Function Dental Assistant (EFDA) • Perform chair side assistant duties in all phases of restorative, surgical, endodontic, prosthodontic and periodontal treatment • Restores teeth prepared by a dentist • Cements crowns, bridges after dentist approval • Takes impressions for partial and full dentures • Adjusts partial or full dentures per dentist approval

  9. WILL THE USE OF MID-LEVEL PROVIDERS RESULT IN A TWO-TIERED SYSTEM OF DENTAL CARE? • New Zealand has employed MLPs since 1921. • If this strategy had been successful, New Zealand would not now be experiencing pockets of oral health disease at the level of regions traditionally characterized by poor oral health status • In some areas the severity is at the level of developing or Eastern European countries

  10. DOES EVERYONE DESERVE THE SAME HIGH STANDARD OF DENTAL CARE? • Some say that some care is better than no care at all? • Others say that we should strive to give children and adults the best care possible? • Ultimately, we should always strive to do what is best for the patient! • Will mid-level providers be the answer in dentistry?

  11. ONE VIABLE PROVEN SOLUTION Use of EFDAs • Federally Qualified Health Centers • Community Health Centers • Private Practice • 501(c)(3) Medicaid Providers Why? • EFDAs extend productivity about 30% • EFDAs maintain direct supervision by dentists

  12. POLICY STATEMENT OF THE AMERICAN DENTAL ASSOCIATION The American Dental Association, by all appropriate means, will strive to maintain the highest quality of oral health care by maintaining that the dentist be the healthcare provider that performs examinations/evaluations, diagnoses, and treatment planning, and that the dentist be the health care provider that performs surgical/irreversible procedures. Surgical procedures are defined as the cutting or removal of hard or soft tissue.

  13. THANKS FOR YOUR ATTENTION! QUESTIONS

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