By Katherine Burgess
February 20, 2017 

Supporters say a bill licensing dental therapists could help fill a void in basic dental services across Kansas. They’re determined to carry on even though the bill didn’t come to a vote in committee during this legislative session.

“We know there’s still support for the bill in the Legislature as a whole and the public, so we will keep moving forward and continuing to work on it,” Katrina McGivern, policy and public affairs director at the Kansas Association for the Medically Underserved, said in a phone interview. “There’s always options for amendments on the floor. There’s ways.”

It’s not the first time supporters have fought for dental therapists. Similar bills were considered in 2011, 2013, 2015 and 2016.

McGivern said she believes such a bill could potentially be brought up in the Senate. If it comes to it, they will continue working on the bill next year.

Rep. Daniel Hawkins, R-Wichita, said Friday that the Health and Human Services Committee, which he chairs, probably wouldn’t have time to get to the dental therapist bill. Monday was the last meeting of the committee, while Thursday is “turnaround day,” the deadline to consider bills in their house of origin.

Bryan Brady, CEO of First Care Clinic in Hays, isn’t sure how many patients have fallen through the cracks in the 13 months during which he’s been unable to hire a second dentist.

The clinic also had to stop seeing dental patients entirely for about 40 days in 2015 after its two dentists left.

“We’re constantly full,” Brady said. “We know there are people who are not being served.”

Brady sees dental therapists as equivalent to a nurse practitioner or physician assistant, but for the dental profession. If he could hire one, he could fill the gap in services at First Care, he said.

Opponents of dental therapists, however, say many surgical procedures should be done only by a fully trained dentist.

The shortage

Currently, 87 counties in Kansas do not have enough dentists, according to Kansas Department of Health and Environment data from December.

In terms of dentists per capita, Kansas ranks 35th in the nation, according to America’s Health Rankings.

McGivern said it’s not just a lack of dentists but also whether dentists accept Medicaid.

There might be a dentist available, but if that dentist doesn’t serve people with Medicaid, that leaves out a population needing care.

The debate

The Kansas Association for the Medically Underserved was one of the co-leaders advocating for House Bill 2139, which would have allowed dental therapists to perform a number of services including cleanings, filling cavities, extracting certain baby teeth and diagnosing dental decay.

If the bill had become a law, dental therapists would have to be licensed through the same exams as dentists, albeit on fewer procedures, McGivern said. Other supporters of the bill included Kansas Action for Children and Oral Health Kansas.

“Dental therapists have been proven safe and effective across the country,” McGivern said. “They’ve been in the United States working for 10 years now.”

Kevin Robertson, executive director of the Kansas Dental Association, said fillings, extracting teeth, cutting into tissue and using a high-speed hand piece are all too complex for someone without years of training.

“We really think it’s more appropriate for dentists to be treating folks in those areas,” Robertson said.

The need for dentists in rural areas should be met through scholarships and working on KanCare, not dental therapists, Robertson said.

Robertson also disputed the idea that 87 counties should be considered dental health professional shortage areas, saying the numbers don’t add up.

In 2011, Kansas’ Bureau of Oral Health and the University of Kansas Medical Center’s Center for Community Health Improvement issued a study listing only four dental care service deserts, containing about 57,000 Kansans.

Philip Newkirk, a dentist in Neodesha, said he’s concerned a dentist might not be there to help in the event of an emergency.

“It’s a quality-of-care issue,” he said. “Sometimes things go wrong.”

He also said Kansas has enough dentists but is not able to serve people because of issues with Medicaid.

“Rather than getting people that are less trained and watered-down providers, if we would let our professionals do more work by increasing Medicaid reimbursement, that would be a more effective way of getting people the care they need,” Newkirk said.

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