Last Thursday, KUOW in Seattle ran a story about the prospects of a new mid-level dental practitioner in Washington State. You can find it here. We appreciate KUOW giving WSDA the opportunity to explain our position, but there were two inaccurate statements that we need to clarify.
1. New bills’ scope of practice – The story includes this information about the proposed practitioner’s scope of practice:
The proposed legislation would add a mid–level provider to today's dental team. The new therapist would be like a nurse practitioner is to a doctor.
Dr. Ray Dailey: "They're called DHAT. Dental Health Aid Therapist. And what they are trained to do is they spend two years of intensive training to do nothing more but minor dental work. They will do fillings, simple extractions.”
Nurse practitioners do not do surgical procedures. HB 2226 and SB 6126 would allow dental therapists to do more than minor dental work – it would allow them to do surgical procedures including pulpotomies (root canals on primary teeth), drilling for cavity preparation, and extractions . These procedures are irreversible and could be performed by an individual with a GED, an unspecific amount of training, and no competency testing. There is no precedent for this midlevel practitioner anywhere else.
2. New bills’ amount of supervision – The story also suggests the proposal would create mid-level practitioners who are supervised by dentists. Dr. Dailey explains how he saw the DHAT function in Alaska -- working under the on-site supervision of a dentist:
"Up in Bethel, Alaska, I had a chance to go up there to see DHATs in action working in a dental clinic and it was great. You had your hygienist providing cleanings and taking care of the gums. You had DHATs doing lots of these fillings. Just one after another. Then you had the dentist doing root canals or doing complex restorations, or providing that upper–tier stuff which is what a dentist gets training for."
But HB 2226 and SB 6126 would allow the mid-level dental practitioner to perform procedures without the on-site supervision of a dentist. Under the bill’s structure, a clinic could be staffed entirely by mid-level dental practitioners, without a dentist on site to help handle complications that might arise during surgical procedures. This fractured model of providing care is one of the main reasons that WSDA opposes the bill.
For a complete explanation of why WSDA opposes the bill, click here.