- The Bismarck Tribune
February 13, 2015
A bill in the Senate would allow advanced practice dental hygienists to work in North Dakota. The idea behind Senate Bill 2354, sponsored by Sen. Dick Dever, R-Bismarck, is to provide care in areas of the state where residents have to travel long distances to see a dentist. The bill makes sense and deserves approval.
The North Dakota Dental Association has voiced its opposition, with Executive Director Brent Holman arguing that there's not enough evidence to show advanced practice dental hygienists are an effective way to address the demand for services. However, Minnesota permits advanced practice dental hygienists, and Maine and Alaska have similar programs.
There’s a need for more dental care in the state, with 40 percent of the state’s counties with one dentist or none, according to Rachelle Gustafson, president of the North Dakota Dental Hygienists' Association. The bill would let dentists hire advanced practice or mid-level dental hygienists who could perform simple procedures such as fillings and tooth extractions. At the moment, dental hygienists in North Dakota handle preventive care, but the bill allows for mid-level practitioners who would work under the supervision of dentists and could go off-site to treat people who have a difficult time accessing services. Hygienists would be able to use video teledentistry to consult with dentists.
The hygienists would have to go out-of-state to get an advanced degree since it’s not available in North Dakota. Minnesota offers the degree and it’s possible, if the bill passes, that North Dakota could lure mid-level hygienists from other states. To develop the program would take time, which is a good reason to approve the bill now. It would give hygienists time to plan for advanced degrees and for dentists to plan for possible satellite offices. The change won’t happen overnight; it could take three years or so.
More dental care is especially needed among the young and the elderly. Both age groups often lack the ability to travel distances for care. Some parents can’t afford to take a day off to take a child to the dentist. Some elderly can’t or don’t want to drive distances, and have no one to take them. A hygienist who lives in their area could provide an exam, consult with a dentist and tell the patient what they need. If they need treatment, they could be spared a long trip for an exam and just go for the treatment. It will save time and reduce travel costs to one trip. The longer people go without care, the more likely they will suffer from related health problems. And who wants to go through life suffering from tooth pain?
The North Dakota Dental Association is backing other bills to improve access to care. Senate Bill 2197 would expand the Seal! ND program that offers sealants to elementary school children and Senate Bill 2205 would simplify a program for dentists to repay their school loans, which Holman said would help those practicing in rural areas or serving Medicaid patients.
These are good ideas, but they don’t take away the need for the hygienist bill. Providing dental care to those who need it won’t be solved by one approach, but through the use of several programs. Similar programs have worked in the medical profession and the Tribune feels this is a sensible proposal that deserves approval.