A bill (SB 541) that would create a new type of mid-level dental care professional, called "dental therapist," cleared a House committee and was sent to the House floor Wednesday.
The bill would authorize licensed dental therapists to perform basic dental procedures like simple tooth extractions and fillings that dentists currently do.
And the bill spells out licensing, education, training, and supervision requirements.
"This isn't about flooding the market with dental therapists," said Amy Zaagman, executive director of the Michigan Council for Maternal and Child Health. "This is about thoughtfully creating an additional team member who could see under-served populations."
"We have areas of the state where we just literally don't have enough providers to care for the population," said Zaagman.
Supporters of the bill include clinics and health centers, many of whose clients are on Medicaid, uninsured or under-insured. Their dentists say having dental therapists would allow them to serve more clients.
Zaagman said the bill is specifically tailored so that dental therapists would serve those in need.
"If this bill passes, it would be the first time that Michigan would be restricting a health care professional to serving really only the underserved population either by geography, by insurance type, or by the setting in which they would work," said Zaagman.
She said the bill provides that dental therapists would be able to practice only in dental shortage areas or in safety net settings like federally qualified health centers or rural health centers.
"If a dental therapist wanted to go work or was asked to come work by a private practice dentist who was not in a shortage area," said Zaagman. "The de ntal therapist would have to see 50% Medicaid or uninsured patients."
Zaagman said that oral health can have a big impact on physical health.
"Also, we know that oral health has an impact on employability. We know it has an impact on school attendance. We know it has an impact on productivity at work," said Zaagman. "And we know it impacts someone's quality of life."
The Michigan Dental Association opposes the legislation.
"We remain firm in the belief that there are an adequate number of providers in our state," said Deb Peters, president of the MDA.
She said the MDA advocates alternative solutions to providing access to the underserved including increasing investment in the state's educational loan repayment program for dental school graduates and raising Medicaid reimbursement rates.
Peters also criticized the the bill's supervision requirements as inadequate.
"As written, supervision in the bill does not mean a dentist is on site when a dental therapist is performing these procedures," said Peters.
The bill passed in the Senate on October 11, 2017. It is up to the House leadership when it will be put up for a full vote by the House.