Dental Health Groups Compromise on Legislation

Oregon Dental Association, Oral Health Coalition emerge from months of mediation with a bill to address dental workforce, access issues

March 10, 2011 --The Oregon Oral Health Coalition and the Oregon Dental Association have joined forces to draft legislation that would create dental care pilot projects intended to address the state’s lack of workforce and access to care.

The amended version of Senate Bill 738 came before the Senate Committee on Health Care, Human Services and Rural Health Policy Wednesday after months of professional mediation between the groups and no small amount of pressure from Sen. Laurie Monnes Anderson (D-Gresham) to broker a compromise.
“The timing of Senate Bill 738 is perfect,” said Monnes Anderson, adding, “It is imperative for our committee to look at all kinds of ways to deal with access and our limited workforce and scope of practice issues.”
The two groups have long sparred over just how to address the issues gnawing at Oregon’s dental care system.
The Oral Health Coalition, along with the Northwest Health Foundation, had supported introducing a new type of mid-level dental provider – known in other states as a dental therapist – to help ease the workforce shortage at a lower cost than training and hiring more full-fledged dentists.
In fact, the Coalition's first stab at legislation this session, Senate Bill 227, called for allowing dental hygienists to receive additional training and practice as dental therapists. Supporters cited a Kellogg Foundation report documenting the success of a dental therapist-driven program in Alaska, and the piloting of a similar program in Minnesota in 2009.
But the Dental Association strongly opposed bringing a new provider into the mix, contending that the Kellogg study was too short-term to be conclusive, and that more energy should be focused on prevention than on scope of practice.
Last December, Monnes Anderson urged the groups to begin a structured mediation process. At Wednesday’s hearing, their mediator, Sam Imperati of Oregon Consensus, declared the process a success. Monnes Anderson agreed.
“Everyone really came to the middle to try to address problems from both groups,” said Monnes Anderson.
Changes to the original legislative concept on which the groups agreed include a provision requiring the Oregon Health Authority to administer any pilot programs and to consult with oral health governing bodies and educational institutions.
The bill does not require the Health Authority to create new classes of mid-level providers, but it does propose enhancing the scope of practice of existing dental health workers known as limited-access permit hygienists.
These hygienists could be authorized to perform more duties than they currently do, and their proposed new title – expanded practice dental hygienist – would reflect that enhanced scope of practice.
“We considered this an opportunity to seek areas of agreement,” said the Oral Health Commission’s Gary Allen.
Dr. Teri Barichello, the Dental Association president, said that she was pleased that the bill had sections focusing on community-based education initiatives.
“Oral health education and preventive care are the keys to extending oral health,” said Barichello.
“I think it’s positive that they’re even talking about [this legislation],” said Judith Woodruff, director of the Health Workforce program at the Northwest Health Foundation. Woodruff was involved in the early stages of legislative brainstorming but was not invited to participate in mediation.
She cautioned, however, that any legislation needs to have maximum flexibility, and can’t be “too restricted by statute,” lest rigid rules be put in place that require legislative action to change and stifle innovation.

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Look at the services and benefits the denturist profession has provided to the Oregon people. The American Dental Association and Oregon Dental Association continues to fight to limit the scope of practice for Oregon Denturists. Gary W. Vollan L.D.

Has anyone taken a good look at this bill??? They are removing the need for schooling to become a community access dental hygienist...and allowing these trainees to do an internship in order to administer local anesthesia. That's outrageous! Imagine the harm that could be done by allowing a trainee to administer injections into the jaw without knowing the anatomy and how/why the local anesthetics affect the body. Not to mention the adverse effects of some local anesthetics for patients with health concerns such as high blood pressure or asthma.