Access to dental care was severely compromised during the lockdown-period of the global pandemic. Since then, a combination of pent-up demand for dental care and a limited supply of dentists, has made the situation even worse. Regulators in Michigan have responded to this crisis in dental care access with rules aimed at expanding access to the underserved community, particularly people of color, children from low-income families, pregnant women, the elderly (defined as anyone over 65 years of age), and people living in rural areas.
The new regulations have been in place since April 2021, and allow dental therapists to get a license to practice. Dental therapists have been trained in preventive dental care and can perform routine restorative treatments such as filling a cavity and tooth extractions. The Michigan Department of Licensing and Regulatory Affairs hopes that by increasing the number of licensed professionals, they can ease the burden on the dental care system and help more Michiganders access dental care.
Regulators were compelled to act as the situation worsened. There are nearly 1.5 million people in Michigan who live in areas with a shortage of dental health professionals, and only just under 400,000 of these people have their dental needs met. The situation is just as dire for Michigan’s children. The Centers for Medicare and Medicaid Services says that 58% of Michigan’s children registered with Medicaid, or some 630,000 children, did not have any access to dental care in 2019.
Dental clinics will be able to expand access to underserved communities by utilizing existing personnel in a broader range of services. So, for instance, if you were to visit a dentist in Saginaw MI, you might now be served by a dental therapist, licensed to provide essential preventive and restorative treatments. It is hoped that federally qualified health centers will be able to take on more Medicaid or uninsured patients, as a result of these regulations.
The regulations were a long time in the making. Essentially, they operationalized Senate Bill No. 541, which was passed into law in 2018, and that permitted dental therapists to fill service gaps which were worsened by the pandemic. There are 13 states which have similar laws and so far, dental therapists have proved to be valuable additions to dentals teams.
One important case is that of Minnesota, which, since 2011, has authorized dental therapists to provide mid-level services: wait times have declined, along with the distances that patients have to travel to get care, particularly in rural Minnesota. Teams are more productive, and patients are more satisfied.
Dental offices and clinics are saving more money and deploying this free cash to investing in treating people from underserved communities, especially those insured under public dental plans. All this has been achieved with hitting revenue or profitability.
Michigan Medicaid is now working to ensure that the state’s dental therapists can quickly enroll and get reimbursement for their work. This is a key step to making the program a success.
If Michigan can achieve the success of states like Minnesota, then millions of underserved people will finally have access to dental care.