To the editor:

Regarding the April 20 Eagle article on increasing access to dental care by creating a mid-level provider (advanced dental hygiene practitioner), dentists in Berkshire County applaud the comments from well-respected pediatric dentists Drs. Louis and Steven Yarmosky and Dr. Lauren Ballinger. We have long been advocates for Rep. Smitty Pignatelli and recognize his passionate mission to increase access to dental care in Berkshire County.

But dentists have multiple concerns that the proposed advanced dental hygiene practitioner (ADHP) is not a solution that will work in practical terms.

It is still unclear if ADHP is having any impact on access to dental care in Minnesota and Maine. Furthermore, the model proposed in Massachusetts is significantly different than those approved in the other states. The Massachusetts proposal requires half as many years of education before these providers are allowed to perform irreversible procedures on children and the elderly. Additionally, this legislation does nothing to require these providers to practice in designated areas of need. As the bill is now written, these midlevel providers could, in fact, be seeing many of the same patients now being treated in dental offices.

I feel that a more effective model in Massachusetts would be a community dental health worker (CDHW). The CDHW would conduct community-based outreach to link residents with a permanent dental home.


The proposed ADHP bill does not address the need to connect patients with a comprehensive dental home, does not take into account ongoing efforts regarding the dental workforce currently in place, and will not result in lower cost or better patient outcomes.

We urge the Legislature to study the bill further and work with "boots on the ground" dentists in our continued efforts to address the oral health needs of the residents of the Berkshires and across the commonwealth. Let's get together and hammer out a result that will make our patients and our constituents proud!

Dr. Jay Wise, Lee The writer is Berkshire District Trustee to Massachusetts Dental Society.