Take time to study proposed dental change

Oregon’s even-year short legislative session runs 35 days. By the time this editorial is in the newspaper, eight of those days will be gone. That means there’s precious little time to do a deep dive into a measure that would make substantive changes to existing systems in the state and that involve people’s health, to boot.

The 2020 Legislature has been asked to approve Senate Bill 1549, which would establish a new job — dental therapist — and create the standards and licensing procedures to go with it. It’s being billed as a good way to bring better dental care to the poor and to those in rural Oregon.

It may well do that.

Then again, the measure could cause problems supporters of the proposal haven’t foreseen. Yet lawmakers, even those on Senate and House health care committees, will have precious little time to study the measure before having to vote on it. Sen. Tim Knopp, R-Bend, a member of the Senate committee, says it doesn’t feel like there’s enough time to really understand what’s being proposed.

He could be right. His committee may spend an hour, perhaps a bit more, hearing from Oregonians on SB 1549.

The bill, if approved, would create a new class of dental workers who could perform many of the services dentists now do, though at a reduced price. That might be great if the new therapists have adequate training. Minnesota, which began licensing dental therapists in 2009, actually has two classes of therapists, with one able to offer more advanced services than the other, and two schools that provide training. And Pacific University in Forest Grove has begun a pilot program to train at least two groups of therapists.

There are good reasons to support a dental therapy licensing program in Oregon, to be sure. About a quarter of the state’s population has limited access to adequate dental care, according to the Kaiser Family Foundation, and dental therapists could take up much of that slack at a price more people could afford.

According to a study by Oregon Health & Science University, some 40% of children on Medicaid in the state received no dental care in 2018, and fully 45% of black children lacked care. Too, some Oregonians have no insurance or have policies that do not include dental care.

Still, as Knopp notes, Oregonians may not want to create a tiered system of dental care, with the poor and those on the Oregon Health Plan receiving a lower level of service than those with enough money to buy better. That, like questions of how to supervise dental therapists adequately and how to provide incentives to make certain rural Oregon is served by the new providers, cannot be answered quickly.

These are all serious issues and they should be resolved before, not after, a dental therapy program is created. Lawmakers should study idea a bit longer, then make the dental therapist bill a priority in 2021.

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