Five Colorado counties don’t have a single dental provider, which means people often drive long distances for routine care.
One in five Coloradans has fair or poor oral health, 53 of Colorado’s 64 counties have a shortage of dental hygienists, and rural adults have nearly double the prevalence of tooth loss compared to their urban counterparts.
In 2018, 28% of Colorado dentists served Medicaid-enrolled patients, and 44% of kindergarteners in low-income schools had at least one cavity. Based on the information collected as if Healthy ColoradoA non-profit that works to influence public policy to improve health care for people in the state.
Legislation passed last year was intended to close gaps in oral health by allowing dental professionals to practice in the state. But it could be years before these mid-level clinics are working in Colorado to make enough of a difference.
On May 1, Colorado will begin issuing permits to those with Completed dental degrees or practiced in the military or licensed in 13 other states where their work is legal. The degree is not offered by any Colorado colleges, nor does the state currently offer a licensing exam.
Currently, those who are interested in the profession must train elsewhere. Alaska, Minnesota and Washington only They have educational programs.
Healthy Colorado, which lobbied for passage last year 219 of Senate BillI hope to work with partner organizations such as the American Academy of Pediatrics, Delta Dental, and the Colorado Community Health Network to create a statewide dental education program.
Clinicians can expand capacity, but where do they train?
Dental therapists, similar to physician assistants, may provide more care than a dental hygienist but less care than a dentist. Therapists can fill cavities, clean teeth, place temporary crowns and perform extractions, for example.
Once a local education program is created, perhaps at the community-college level, Coloradans will begin to see many more dental professionals, supervised by dentists, working in dental clinics, schools, mobile clinics, nursing homes and other community settings, he said. Kyle Piccola, Vice President of Communications and Advocacy for Healthy Colorado.
A study in Massachusetts, one of the states considering allowing the practice, suggests that adding a dental hygienist to a clinic would expand capacity by 1,920 appointments.
“It’s proven to be really safe, and it’s important to show that it has really amazing health effects for people,” Piccola said. “In the end, this is going to be a really big deal.”
At least one critic said it’s unclear if there is enough state funding to help educate and train dental professionals, especially if Colorado already has it. It invests in higher education including dentists and dental hygienists.
Colleen Lampone, president of AFL Enterprises, a public health contracting firm in Denver, is the former executive director of the National Network for Oral Health Access. She supports bringing dental professionals to Colorado, but says Senate Bill 219 is flawed.
We don’t have enough resources to train our dentists and dental hygienists and now they want to add a whole new profession, with a new curriculum and new graduation requirements. “Where do people come from to teach these courses and how do we pay?”
The University of Colorado School of Dentistry said it has suspended its dental hygiene program indefinitely due to cost concerns. The last class of CU dental hygiene students graduated in May 2009.
Piccola said Senate Bill 219 only creates the mandate and authority to license dental practices, and Healthy Colorado leaders are working with state budget secretaries and community colleges to seek funding for a new dental education program.
In other states, dental education programs have been established through local partnerships and private and public funding, Piccola said. “This is an effort to build a pipeline of dental professionals to address oral health.”
Colorado Consumer Health Initiative held Study of 2022 To assess the oral health needs and practices of Coloradans.
Despite the desire for good dental health, half of the 422 respondents said they had oral disease or were self-conscious about the appearance of their mouths. Forty-seven percent of respondents who need urgent care say they have to wait more than a month for an appointment, and 73% say they don’t get care because it’s too expensive.
“The mouth is a part of the body, and if you have gum disease, it makes it harder to control diabetes, and we’ve learned that it probably has an effect on heart disease,” Dr. Terry Batliner said. A Colorado dentist who has worked with dental therapists in other states, including some in more remote parts of the country.
“It’s important for people to get a job, keep a job and look good when they’re working in the wider American community,” he said. Missing teeth, he said, “is really a big blow to people.”
Dental professionals are especially needed in mountainous, rural communities.
Dental health problems are the leading cause of school absenteeism for Colorado children.
Batliner, a member of the Cherokee Nation of OklahomaHe was associate director of the Center for Native Oral Health Research at the Colorado School of Public Health and To help the WK Kellogg Foundation expand access to dental care in US communities.
Dentists said dentists are especially needed in mountain communities and rural Colorado, where few dentists are available. Dental professionals can help reduce the cost of oral care.
“They are paid between what a dentist and a dental hygienist are paid,” he said. “So they often offer the same things that the dentist offers, but they don’t get paid as much, and that can keep costs down for people.”
Hiring local providers who understand the unique stresses and issues in their area will help them effectively communicate with their patients about how to prevent disease because they can better relate to them, he said.
“That happened in Alaska,” said Batliner, who was one of several people who testified in the Capitol last year in support of Senate Bill 219. “The majority of dentists in Alaska are Alaska Natives.”
As of October 2021, Alaska had licensed 36 dental professionals. Minnesota, which has three training programs, had 133, according to the American Dental Association.
Dr. Carol Niforatos testified in support of the bill. She oversees the dental program at the Colorado Collaborative for the Homeless, which provides care to about 6,000 people a year. Most of the firm’s clients are homeless people who never return for appointments.
“I support any proposed improvement in access to care for underserved populations,” Niforatos said. “Vulnerable populations require the type of services that dental therapists are licensed to provide, including the basic level of urgent needs and removal of teeth that are causing pain or inflammation to patients.”
Adding dental professionals to Colorado offices has been discussed for about a decade, Niforatos said, adding that she hopes to add such a provider to her office.
Overall, the number of dental hygienists working in the U.S. is declining, she said, with falls occurring during the pandemic.
“They’re in very short supply,” she said, “so dental therapists may be able to fill those needs because of the shortage of hygienists.
Information on how to become a licensed dental practitioner in Colorado is available along with a checklist. Colorado Board of Dentistry website.