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March 11, 2013

Bill sees role for dental practitioners in Massachusetts

(Continued)

The legislation would take it a step further by allowing dental practitioners to perform nonsurgical tasks, including pulling teeth or filling small cavities — but only when such procedures do not require root canal, periodontal surgery or other more complex intervention.

“It would bridge that gap between what public health hygienists can do and what dentists can do,” said Katherine Pelullo, who chairs the Council on Regulations & Practice for the Massachusetts Dental Hygienists’ Association.

In more than half of the state’s 351 cities and towns, no dentists accept MassHealth, the state’s Medicaid program, and 53 percent of children in families eligible for MassHealth did not see a dentist in 2011, according to the association. Additionally, the group says, more than 600,000 residents live in areas of the state designated as having a shortage of dentists, and elderly in nursing homes often go without dental care.

The Division of Health Care Finance and Policy estimated that 31,000 hospital emergency room visits in 2011 resulted from preventable dental crises.

Supporters of the bill say they do not foresee a huge rush by current dental hygienists to become advanced practitioners. Achieving that designation would require an additional 12-18 months of study in a master’s level program, along with 500 hours of practice under the direct supervision of a dentist and other requirements.

Still, many dentists are wary.

“It clearly is a major change in the practice paradigm in oral health,” said Dr. Paula Friedman, president of the Massachusetts Dental Society and professor at Boston University’s Henry M. Goldman School of Dental Medicine.

“I have real concerns about safety of the public from someone who has only had 18 months of postsecondary education. The reality is that many people feel four years of dental school is not enough to teach people what they need to know,” Friedman said.

The dental society has yet to take a formal position on the legislation. Friedman says it needs more vetting. Chandler said lawmakers are prepared to address concerns about safety and training and fine-tune the bill if necessary.

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