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Senate Approves Dental Hygiene Practitioner Amendment

Senate Approves Dental Hygiene Practitioner Amendment

May 25, 2016

Oral Health is overall healthIn a stunning 39-0 unanimous roll call vote, the State Senate today voted to add Senate Majority Leader Harriette Chandler's amendment authorizing a new type of dental professional to serve our most vulnerable populations.

The amendment would create a new midlevel dental provider, the Dental Hygiene Practitioner (DHP). DHPs are dental hygienists who – after completing additional training – are able to deliver basic but critically necessary care to underserved populations in the state. DHPs will work under the general supervision of a dentist, using telehealth technology to share X-rays and patient records with the dentist and consult on complicated cases.This will allow DHPs to bring care directly to people in schools, nursing homes, and other community settings. DHPs will deliver critical dental services like filling cavities, placing temporary crowns, and extracting loose teeth.

In 2014, just 35% of dentists treated a MassHealth patient and only 26% billed at least $10,000 to the program. Furthermore, Massachusetts has 62 federally designated dentist shortage areas including 69 cities/towns with no dentist at all; an estimated 244,000 people in those areas are not able to have their dental needs met.Despite recent progress on health care, many residents in Massachusetts struggle to access dental care, and a person’s ability to receive adequate dental care is largely determined by age, race, income, insurance status, and geography. If you are a senior living in the Berkshires or a child on MassHealth in South Boston, the reality is the same: it may be hard to get adequate dental care.

HCFA's Executive Director, Amy Whitcomb Slemmer, praised passage of the provision:

"As we envision a more patient-centered health care system that integrates oral health, we must embrace alternative strategies that make it easier and more affordable for children and families to access the dental care they need. Passage of this provision is a crucial step forward as it will expand the dental team and give dentists the ability to bring care directly to patients in the community."

Similarly, yesterday the Boston Globe published an op-ed by Dr. Donald Berwick that summed up all the reasons to support creation of DHPs:

Proper dental care is as much a human right and as smart an investment as is proper medical care. By passing the Dental Health Practitioner legislation, Massachusetts now has a chance to add access to dental health to its list of proud commitments.  

This was brought out in detail by Senator Chandler in today's Senate debate:

All the problems one gets in oral health can end up in an emergency room and can be life threatening, deaths can be caused as a result. I know we don't always think of it that way.... This will bring good oral health to literally thousands of people who do not. There are so many people in nursing homes who took care of their teeth for years and now there are no dentists who will go there. These people  [DHPs] will go to nursing homes, they will go into school and other places dentists just don't go into. The fact is that we have studies that show that it costs between 4 and 9 times more to have your treatment in an emergency room than it does with a hygienist or dentist.

The provision's fate will now be up to a House-Senate conference committee, which will meet during June to hammer out a final budget. There is no equivalent provision in the House version of the budget. The strong vote today sends an important message to the conference that this is a top Senate priority.

                     -- Brian Rosman