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March 11, 2013

Bill sees role for dental practitioners in Massachusetts

BOSTON — Dental hygienists with advanced training could perform certain procedures now reserved for dentists, including routine fillings and tooth extractions, under a bill that supporters believe would improve access to oral health care for low-income Massachusetts residents and underprivileged children.

The legislation would create a new, midlevel position called advanced dental hygiene practitioner, similar to a nurse practitioner in a physician’s office and comparable to dental therapists that operate in more than 50 other countries. The proposal is being viewed with some alarm by dentists, who are worried about patient safety and adequacy of the training requirements contained in the bill.

“We love our dentists. They do a good job, but there are not enough of them,” said state Sen. Harriette Chandler, D-Worcester, who has sponsored the bill along with Rep. William “Smitty” Pignatelli, D-Lenox.

A dental practitioner would not supplant the traditional family dentist nor prompt any fundamental realignment of responsibilities in a typical dentist’s office, backers insist. In fact, the vast majority of people with dental insurance who see a dentist regularly for cleanings and other services would likely encounter no change in routine.

But for the poor, the uninsured and those who live in parts of the state where there are too few dentists, the advanced hygienist could provide access to preventative care that is otherwise not available.

“It is long overdue,” said Jacklyn Ventura, a dental hygienist who directs Mass Healthy Smiles, a private organization that offers screenings and other services, such as cleanings and fluoride, to children in community settings such as public schools and day care facilities.

“Dentistry is so expensive. When families have more than one child, it can put them back six months just to have regular visits,” Ventura said.

Supporters see the bill as a natural extension of a 3-year-old Massachusetts law that allowed professionals like Ventura to provide typical dental hygiene services in public settings without direct supervision from dentists.

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