New legislation calls for more extensive dental hygienist training
BOSTON — State Rep. William "Smitty" Pignatelli has teamed up with state Sen. Harriette Chandler, other lawmakers and oral healthcare professionals to champion a bill that would enhance the training of dental hygienists — who primarily clean teeth — so they can also fill cavities, place a crown on a chipped tooth or pull a loose molar or bicuspid.
Backed by data from several studies, Pignatelli noted children on MassHealth and low income senior citizens are the populace most likely missing out on proper dental care. He says the dental access bill can help close that gap.
"Oral health equals overall health and their are great inequities in access in the Berkshires," he said in a phone interview last week from his Boston office.
"A striking number of children haven't had a cleaning in the past year and an expanded oral health workforce would help," added Amy Whitcomb Slemmer, executive director for Health Care for All.
The Boston-based advocacy group cited nearly half of Massachusetts young people ages 1 to 21 — 290,000 enrolles of MassHealth didn't see a dentist in 2014.
Furthermore, studies show the majority of low income senior citizens, seniors in long-term nursing facilities and special needs adults are also underserved, many suffering from tooth decay and/or missing several to all their teeth.
The legislation in it's current form calls for a licensed dental hygienist seeking a masters in dentistry:
• Complete an additional 12-18 months of education
• Passing a clinical exam
• Practicing under the direct supervision of a dentist for at least 500 hours before practicing under general supervision
• Obtaining professional liability insurance
The Massachusetts Dental Society agrees better access to oral health care is need, but finds the proposed legislation isn't comprehensive enough. The dentists group says the bill fails to address how to deal with those with language barriers, are unsure of their dental insurance benefits, educating patients about the importance of good dental hygene and getting oral checkups on a regular basis.
"While we agree that we can do better as a commonwealth, we believe that more comprehensive solutions can and should be developed," said society president, Edward Swiderski in an email to The Eagle.
Proponents of the bill say this is similar to a nurse practitioner working in a doctor's office and isn't intended to replace dentists.
"This is still under supervision of a dentist," Pignatelli said. "Dental hygienists won't be hanging out their own shingle."
With about half of the Berkshires 63 dentists over the age of 60, Pignatelli hopes those hygienists with advanced training would consider becoming full fledged dentists.
If the bill becomes law, Massachusetts would join Alaska, Minnesota and Maine who have created dental therapists, Alaska being the first in 2004.
The nation's 50th state have increased access to care for 40,000 people living in 81 rural communities, thanks to dental therapists, according to oral health care advocates.
In Minnesota, savings from the lower costs of dental therapists have allowed dental practices there to treat more Medicaid and uninsured patients.
Many Massachusetts dentists currently don't accept MassHealth or Medicaid patients, and that needs to change, according to Slemmer.
"The mouth is truly part of the body and we need to treat it that way," she said.