Pierce County Dental Society President Dr. Sammy Pak penned an editorial last week in the Tacoma News Tribune. The piece was in response to an editorial written in support of SB 6126 which would allow midlevel providers to perform surgical procedures without the on-site supervision of a dentist. Here's the piece:
Re: “Our state’s dental system is letting too many patients down” (Viewpoint, 1-29).
Anita Rodriguez recently argued on this page for a new category of mid-level dental provider authorized to practice independently from a dentist.
Rodriguez explained that many dentists oppose this proposal because of concerns for safety and quality of care. She also argued that such practitioners are much the same as the nurse-practitioners of 50 years ago – a profession once opposed by the establishment and now embraced by it.
I wanted to provide some clarity on many dentists’ views on this matter.
Rodriguez is writing in particular about two bills that are currently being considered by our Legislature. Both would create practitioners who, with an unspecified amount of training after high school, could perform irreversible procedures that include drilling and extractions without the on-site supervision of a dentist.
We have three concerns with these bills.
• We are concerned about the seriousness of the procedures these mid-level practitioners could perform. The measures would allow dental therapists 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 mid-level practitioner anywhere else.
To Rodriguez’s point about nurse practitioners: Nurse practitioners cannot perform surgical procedures, and in our state they are required to receive a master’s or doctoral degree.
• We are concerned about fracturing the dental home for patients. Under the structure of these bills, a patient with complications from a practitioner’s procedure would need to rush to a dentist to address the issue or wait for the dentist to come to him or her. Nearly every dentist can tell a recent story of a procedure that was more complicated than he or she expected.