How My Practice Benefited from Dental Therapists

Midlevel providers can help communities and office productivity

John T. Powers, DDS

Last year, the American Dental Association estimated that 181 million Americans would not see a dentist.1 I am thankful to live in a state that has given me a tool to extend my care to more patients while growing my private practice. I have the ability to hire dental therapists, and doing so has changed my business—and my community—for the better.

My practice serves patients in Montevideo, Minnesota, a rural town of 5,300 people that is more than 2 hours away from Minneapolis. I’m actually closer to the South Dakota border than the biggest city in my own state. In February 2012, I hired a dental therapist. She was previously a dental assistant in my practice for more than a decade. I knew and trusted her, so when she expressed interest in becoming a dental therapist to advance her career, I told her that I would hire her in that role after she finished the educational program at the University of Minnesota dental school. Having completed the program, she can do a number of additional routine procedures, including drilling and filling cavities.

Practice Benefits

While it took a little time to adjust to having someone in a different role, productivity improved within the first year that the dental therapist began to practice. Patient visits increased by 27% and new patients increased by 38%. My practice also saw more than 200 additional Medicaid patients. As a result of this increased volume, I was able to re-open an unused operatory.

In addition to expanding my patient base, hiring a dental therapist financially benefited my practice. Between 2011 and 2012, billings and collections significantly increased. After subtracting the cost of employing the dental therapist, including the staffing cost of a supporting dental assistant, my practice earned nearly $24,000 in additional profit. This increase was despite Minnesota having one of the lowest Medicaid reimbursement rates in the country.

Adding a midlevel provider to the practice also changed what I do. I now conduct more exams and complex procedures. For example, from 2011 to 2012, I performed 40% more root canals and 49% more patient exams.

In hard numbers, this change translated to 555 more exams, 55 more root canals, 12 more implant procedures, 110 more surgical extractions, and 88 more removable prosthodontic procedures in 1 year. I have more time for implants, cosmetic dentistry, and sedation patients. This change has also made my days more interesting and fulfilling. As you would expect, the number of restorations I perform dropped because I can delegate those to the dental therapist.

Adding a dental therapist has been so successful in helping me reach patients who had not previously been able to get regular dental care that I have now hired a second full-time dental therapist and a third dental therapist who works part-time. Being able to diversify my team to reflect the needs of my community has given me more flexibility to run my practice efficiently and care for people whom I could not reach before.

Final Thoughts

Research shows that dental therapists provide high-quality care, and that dental care teams that employ midlevel providers can reduce the rate of untreated decay more than teams that employ only dentists.^2,3 As such an employer, I see it firsthand. My experience demonstrates that hiring dental therapists can help dentists get timely care to patients in need. Since incorporating dental therapists into my practice, I have seen the oral health of many families improve because they are finally able to receive regular treatment.

Given the opportunity, I believe that solo practitioners can address barriers to care in their community and increase their practice’s bottom line if states allow them to hire dental therapists.

References

1. American Dental Association Report to Congress Addresses Barriers to Access. American Dental Association website. www.ada.org/en/press-room/news-releases/2014-archive/may/report-to-congress-addresses-barriers-to-access. Accessed November 23, 2015.

2. Nash DA, Friedman JW, Kardos TB, et al. Dental therapists: a global perspective. Int Dent J. 2008;58(2):
61-70.

3. Wright JT, Graham F, Hayes C, et al. A systematic review of oral health outcomes produced by dental teams incorporating midlevel providers. J Am Dent Assoc. 2013;144(1):75-91.