[T]he Senate is poised to pass a bill to license mid-level dental practitioners, after voting 18-10 Thursday to give the bill preliminary approval.
The bill, S.20, is scheduled for a final vote Friday. If it were to become law Vermont would be just the fourth state to create such a license, with Maine being the most recent to do so in 2014. Previous efforts to pass such a law in Vermont have died in committee.
Advocates say there is a shortage of dentists in the state making it difficult for many people, especially Medicaid patients and residents of rural areas, to access oral health services. Licensed dental therapists would make it possible for dental practices to accept more patients.
Four counties, Addison, Bennington, Grand Isle and Orange, don’t have safety-net settings where low-income, uninsured or underinsured patients can receive dental care, and in 2013 there were 6,000 emergency department visits for oral health problems in Vermont.
The legislation is opposed by the Vermont Dental Society because dentists are concerned about the adequacy of training for the proposed license. Instead, the society would prefer to focus on recruiting more dentists to the state. They also want the state to step up investments in existing programs at schools and nursing homes.
Senators opposed to the bill questioned the ability of dental practitioners to obtain malpractice insurance, and whether there would be sufficient demand from dental practices to make the new license worthwhile.
But those concerns were outweighed by support for addressing Vermont’s oral health access issues. Sen. Baruth, D-Chittenden, said opponents had not offered a viable low-cost alternative.
The Senate approved an amendment offered by Sen. Jane Kitchel, D-Caledonia, requiring that dental therapists work in practices that serve a “significant volume” of low-income, uninsured or underserved patients. The Health Department would be tasked with determining what a significant volume is.
S.20 allows people already licensed as hygienists to enter a graduate program and become licensed to perform many of the same services as a dentist. The new class of provider, a dental therapist or dental practitioner, would practice under the direction of a dentist.
Hygienists must complete a three-year program. The certification for a dental therapist requires an additional year of classes. Previous versions called for 400 hours of clinical training, but the Government Operations Committee increased that to 1,000 hours.
Vermont Technical College, which already offers hygienist training, is prepared to offer curriculum for dental therapists.
