April 26, 2021 – Why does health care from the neck up—like oral health—continue to be treated differently from the neck down?

Last year, Massachusetts restored the remaining oral health services that were cut from the MassHealth program a decade ago. However even with this change, many residents will continue to struggle to access dental care and see a dentist or other oral health provider. Data from the Kaiser Family Foundation found that there are 56 federally designated dental shortage areas in the state and estimated that 325,211 residents have an unmet dental need due to this shortage. In addition, the 2020 Massachusetts Health Insurance Survey from the Center for Health Information and Analysis (CHIA) found that 20.5 percent of adults between the ages of 19-64 reported having unmet medical and dental care needs due to cost. The survey also found that Black and Latinx families were more likely than white families to have unmet medical or dental care needs.

In order to close these gaps, it is imperative to address the oral health provider shortages and create additional pathways to access care by licensing a new type of oral health professional—Dental Therapists. Dental Therapists are already practicing in five states including Minnesota and Washington. and they are authorized in seven other states. They can deliver critical dental services like filling cavities, placing temporary crowns and extracting loose teeth. They also have the ability to provide mobile services, which would enable them to bring care directly to people in schools, nursing homes and other community settings, especially where there are dental shortage areas. The licensing of Dental Therapists would also provide an economic opportunity for more people seeking a career in the dental profession who want to serve in their own communities. Dental therapy certification is a 3-year program, which can be completed straight out of high school, making it more affordable and less time-consuming than traditional doctoral dental medicine or surgery programs.

Health Care For All (HCFA) is working with a coalition to advocate for the licensure of Dental Therapists in Massachusetts in accordance with the Commission on Dental Accreditation (CODA) recommended model that does not require a masters degree. In March, HCFA brought groups together to discuss the question, “What is a Dental Therapist?” at a winter session of our Health Justice Academy, a virtual training, organizing and community-building program that works to maximize grassroots efforts to advance health justice. The group discussed the health challenges currently affecting communities, examples from other states of how Dental Therapists have helped to address similar challenges, and opportunities for how grassroots members and partners can get involved in advocacy moving forward.

To better understand the oral health access challenges faced by different communities and regions in the state, as well as how Dental Therapists might help to address these challenges, HCFA is calling for passage of a bill to establish a special commission and oral health needs assessment. The current data we have is decades out of date, and this legislation introduced by Rep. Hogan and Sen. Chandler-HD.2962/HD1526 – would help us understand the challenges we face and the policy solutions best suited to ensuring access to dental services.

There is still much to do to address oral health access and disparities in Massachusetts, and we look forward to continuing to work together with our partners to advance the effort to make dental care equitable and accessible for everyone in the Commonwealth. To learn more about ways to get involved or share your story, please reach out to Noemi Uribe at nuribe@hcfama.org.

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