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PrattTribune - Pratt, KS
  • New class of provider could fill dental gap in Kansas

  • Ninety-one Kansas counties, including Pratt, are considered to be underserved and 14 of them don’t have any dentists at all. A solution, according to Kansas Action for Children, lies in training and licensing midlevel providers, in much the same way that nurse practitioners and physician assistants have extended access to medical care.


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  • Ninety-one Kansas counties, including Pratt, are considered to be underserved and 14 of them don’t have any dentists at all. A solution, according to Kansas Action for Children, lies in training and licensing midlevel providers, in much the same way that nurse practitioners and physician assistants have extended access to medical care.
    The political action committee is part of a coalition asking the Kansas Legislature to approve the creation and licensing of a new profession this year, in a pair of bills, HB 2280 and SB 192.
    Under the proposal, dental hygienists could become registered dental practitioners though additional training to provide some of the same restorative care as dentists, working under the supervision of dentists. Since 2005, dental health aide therapists trained in a two-year program have treated native tribal populations in remote areas of Alaska. In 2009, Minnesota lawmakers authorized the creation of a bachelor’s level dental therapists and master’s level advanced dental therapist.
    Dentists and the professional groups that represent them have opposed such providers because they believe midlevels would lack the requisite training to perform complex procedures while protecting patients from harm.
    Proponents counter that physicians were wary of nurse practitioners and physician assistants when they entered the health care system about 40 years ago.
    “I’m not in favor of this,” Dr. James Van Blaricum, retired Pratt dentist, said. “I think it will open the profession to problems. You can put in a filling but there are all sorts of things around there that if you don’t recognize them, could lead to trouble.”
    He does agree, however, that many Kansans do not have access to dental care within their communities.
    Dental care is not just about attractive, healthy teeth. Untreated dental problems can result in major medical problems, including heart disease, diabetes and stroke. Dental-related problems burden community hospitals and clinics through costly emergency room visits and uncompensated care, according to information at the KAC website, www.kac.org. The organization said 6,000 emergency room visits per year can be attributed to dental problems and that 55 percent of third graders have experienced tooth decay despite the fact most have dental insurance.
    A problem with attracting dentists to rural counties is that there isn’t enough population to support them, given the high cost of setting up a practice and buying all the equipment, Van Blaricum said. Most physicians today are employed by hospitals, he said, while most dentists are on their own.
    Van Blaricum suggested mobile dental clinics as a partial solution. A dentist could travel to one area in a large motorhome specially equipped as a clinic, take care of dental problems there and move on to another county. Counties or areas could help outfit a mobile clinic, in the same way that county hospitals receive some tax funds.
    Page 2 of 2 - A Pittsburg dentist, Dr. Daniel Minnis, favors the proposal to license midlevel practitioners, according to a story commissioned by Kansas Action for Children.
    He said Kansas would benefit greatly from developing a midlevel practitioner from the state’s pool of dental hygienists who have already had significant training in oral health care.
    Shannon Cotsoradis, president and CEO of Kansas Action for Children, said it’s not clear how long it would take for registered dental practitioners to begin practicing in underserved areas of Kansas.
    “In theory, if the legislation passed this year, it would take a full year to get the training up and running,” she said. “But you potentially could be looking at having, in as quick as two years, people who are licensed in that field.”

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