After resisting for years, Massachusetts dentists are now throwing their support behind legislation that would create a new kind of midlevel provider of dental care.
Advocates say these workers, called dental therapists, would provide much-needed routine dental care, particularly to low-income patients. A few states, such as Minnesota, already allow for dental therapists, and other states have considered similar legislation.
Dentists traditionally have opposed such bills, arguing that dental therapists lack sufficient training to provide high-quality care.
But after more than a year of negotiations with lawmakers, officials at the Massachusetts Dental Society said they now support a new compromise bill. The Legislature’s Joint Committee on Public Health backed the measure Tuesday night. It still needs approval from the full House and Senate, as well as Governor Charlie Baker, to become law.
Baker administration officials have previously expressed support for dental therapy legislation but have not commented on the latest bill.
The compromise would require dental therapists to have a master’s degree and to pass a clinical exam. For the first 2,500 hours or first two years of practice, whichever is longer, dental therapists would have to work under the direct supervision of a dentist, and in the same location as that dentist. After that, dental therapists would remain under the general supervision of a dentist, but they would be allowed to treat patients in other locations, such as schools and nursing homes.
The bill would also require that at least half of the patients dental therapists serve be poor, elderly, or otherwise considered “underserved.”
“It’s not a perfect bill, but it’s a very good bill, because both sides gave a lot,” said Dr. David P. Lustbader, president of the Massachusetts Dental Society, which represents about 5,000 dentists in the state.
“I think it’s going to be model legislation in the rest of the country. We’re the first dental society to embrace the concept” of dental therapy.
Dental therapists would be allowed to provide some of the services now done by dentists, but probably at a much lower salary. Complex procedures would still be done by dentists.
Representative Kate Hogan, a Democrat who serves as House chairwoman of the Joint Committee on Public Health, led the talks that resulted in the compromise.
“By authorizing dental therapists to practice in Massachusetts,” Hogan said in a statement, “we are increasing the number of providers who have the training and flexibility necessary to reach our underserved residents and treat everyday dental problems, ensuring individuals get the care they need before problems persist.”
Senate President Harriette L. Chandler said the bill “will improve . . . overall health across the Commonwealth, particularly for our most vulnerable residents.”
Initially, the dental society clashed with supporters of dental therapy legislation — including the Pew Charitable Trusts — over the level of training and supervision for therapists.
Dentists also argued that the evidence of success in Minnesota — where dozens of dental therapists work — has been lackluster.
Pew officials, however, pointed to studies that show dental therapists have provided safe care, particularly to underserved populations.