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ADA responds to Kellogg Foundation report on workforce innovations

Battle Creek, Mich.—The W.K. Kellogg Foundation Dec. 16 released a report that advocates "midlevel" dental providers, who would perform some surgical procedures, as a solution to the nation's oral health care access crisis.

The report, Training New Dental Health Providers in the U.S., written by Dr. Burton L. Edelstein, president of the Children's Dental Health Project, a nonprofit pediatric oral health policy organization in Washington, D.C., analyzes a variety of "midlevel" dental provider models used in the U.S. and internationally and how they could help increase access to dental care in underserved areas.

ADA President Dr. Ron Tankersley issued a statement questioning some of the reports premises.

"We agree that innovations to the dental team can help alleviate these disparities, said Dr. Tankersley. "We disagree, however, with the foundation's recent report that recommends expanding the functions of non-dentists to include surgical procedures."

The report examines a variety of provider types, including basic and expanded function dental assistants; basic and expanded function dental hygienists; international dental therapists and dental hygienist/therapists; Alaska dental health aide therapists, or DHATs; Minnesota basic and advanced dental therapists; and the ADA-designed Community Dental Health Coordinator in the context of changing and new roles for those positions to create "midlevel provider" models.

Dr. Tankersley outlined ADA positions on workforce innovations, emphasizing that any new dental team member should focus on prevention and education, " which ultimately will be the primary factors in stemming the tide of untreated disease," adding, "The ADA's commitment to this principle is evidenced by our creating an educational curriculum and funding educational programs for Community Dental Health Coordinators, whose primary functions will be education, disease prevention and linking those patients in greatest need of restorative care with dentists who are willing to provide that care."

Dr. Tankersley also called for restoration and increase in funding for federal and state health programs, such as Medicaid and the State Children's Health Insurance Program, to help increase access to dental care.

"The principal barriers to underserved populations receiving the same dentist-provided care as other citizens are program underfunding and bureaucracy. We should begin there, rather than looking to new, untested workforce models as a stopgap solution," Dr. Tankersley said.

"The ADA is committed to leading the way toward better oral health for all Americans, and we will continue working and advocating for the changes needed to make that happen," Dr. Tankersley added. "We welcome the W.K. Kellogg Foundation's interest in and commitment to improving the oral health of the millions of people who currently lack access to dental care. Too many people in this country, including children and adults from disadvantaged families, people living in remote areas, people with disabilities and the vulnerable elderly, suffer from painful untreated dental disease."

The report and summary are available on the W.K. Kellogg Foundation Web site: