“Alaska allowed Dental Health Aide Therapists to do simple dentistry. “
Their definition of “simple dentistry” included injecting a drug (local anesthetic) into someone’s body and filling a cavity in a tooth.
That sounds pretty simple...until the patient has an anaphylactic reaction, or goes into v-fib from the epinephrine in the injection. Or perhaps they develop an infection that needs a root canal or antibiotic. Which antibiotic and why? Will it interact with their other medications? What if the patient has reduced kidney function? Can you still use the same dose of antibiotic? What about high blood pressure? Local anesthetic with epi still OK? How much is OK? Is that lesion on the side of the tongue next to the tooth a traumatic ulcer from biting the tongue? Or is it benign migratory glossitis? Or perhaps invasive squamous cell carcinoma?
I went to four years of college, followed by four years of dental school, and took a two-day written National Board exam, followed by a three-day hands-on state board exam. All to do “simple dentistry”.
When you go to your physician’s office, you might be content seeing the nurse or nurse practitioner. I want to see the Dr.
J Am Dent Assoc, Vol 139, No 11, 1530-1535.
Assessment of Treatment Provided by Dental Health Aide Therapists in Alaska
A Pilot Study
Kenneth Anthony Bolin, DDS, MPH
Background. Dental health aide therapists (DHATs) in Alaska are authorized under federal law to provide certain dental services, including irreversible dental procedures. The author conducted this pilot study to determine if treatments provided by DHATs differ significantly from those provided by dentists, to determine if DHATs in Alaska are delivering dental care within their scope of training in an acceptable manner and to assess the quality of care and incidence of reportable events during or after dental treatment.
Methods. The author audited the dental records of patients treated by dentists and DHATs who perform similar procedures for selected variables. He reviewed the records of 640 dental procedures performed in 406 patients in three health corporations.
Results. The author found no significant differences among the provider groups in the consistency of diagnosis and treatment or postoperative complications as a result of primary treatment. The patients treated by DHATs had a mean age 7.1 years younger than that of patients treated by dentists, and the presence or adequacy of radiographs was higher among patients treated by dentists than among those treated by DHATs, with the difference being concentrated in the zero- to 6-year age group.
Conclusions. No significant evidence was found to indicate that irreversible dental treatment provided by DHATs differs from similar treatment provided by dentists. Further studies need to be conducted to determine possible long-term effects of irreversible procedures performed by nondentists.
Clinical Implications. A need to improve oral health care for American Indian/Alaska Native populations has led to an approach for providing care to these groups in Alaska. The use of adequately trained DHATs as part of the dental team could be a viable long-term solution.