Mid-level dental care critical for Berkshires

To the editor:

I would like to thank and applaud state Rep. "Smitty" Pignatelli for his long-standing commitment to the expansion of quality oral health care across all of Massachusetts. As The Eagle wrote, he is the lead House sponsor of a bill that would markedly increase access by creating a mid-level provider, a dental hygiene practitioner (DHP), modeled after the nurse practitioner model of care.

The DHP would be a licensed dental hygienist who has completed educational requirements equivalent to other mid-level practitioners such as nurse practitioners and physician assistants. Like them, DHPs would expand access to underserved areas and low-income populations. This has already been demonstrated by mid-level dental practitioners in Minnesota, where 78 percent of patients seen by these practitioners are publicly insured.

To expand access, it is necessary to create a new highly trained and educated mid-level practitioner who would establish a collaborative agreement with a licensed dentist, as opposed to adding additional duties to lower-level practitioners. Expanding the responsibilities of existing practitioners, such as a dental assistant, is not the correct approach. As compared to the four-plus years of education that a DHP would be required to complete, a dental assistant may only need two years of formal education in the field, or perhaps even less.

The curriculum for DHPs builds on licensed dental hygienists' training and includes a more rigorous licensing exam. These additional requirements allow DHPs to have a larger scope of practice where the level of education and experience directly correlates to increased public safety and greater expertise.


I'd also like to clear up the misconception that public health dental hygienists (PHDHs), established by the omnibus oral health legislation of 2010, are not making a marked difference. Every day, many of the most vulnerable residents of the commonwealth, often children and elders, receive much-needed oral health care from PHDHs. The existence of PHDHs does not cost the state anything, and yet saves the state thousands of dollars in unnecessary expenditures on oral health care, including in emergency rooms.

Access to dental care is an especially salient issue in the Berkshires, which lacks care for low-income individuals with public insurance. Creating a mid-level dental practitioner will increase the number of highly skilled dental providers and will ensure greater access for publicly insured individuals.

Joanne Simpson, Lee The writer is past president of the American Dental Hygienists' Association — Massachusetts, Berkshire.