There’s a debate shaping up in Alaska regarding whether dental therapists should be allowed to perform procedures such as administering fillings and completing extractions. Alaska is currently the only state which allows for dental therapists to perform invasive procedures; ten other states are considering legislation to expand (or recognize) the role of dental therapists in a similar manner per this New York Times article.

The debate highlights multiple hot topics in health care discussion today:

• Access to healthcare (The therapists, who receive two years of training, help fill a vacuum: Alaska has long had trouble attracting and retaining licensed dentists. Given Alaska’s huge size and rural population, for many state residents a trip to the dentists – or any health care practitioner – can be a lengthy event.).
• The ethnic and socioeconomic divide in health care: 60 percent of Alaska Native children ages 2 to 5 have untreated decay, and 20 percent of Native adults over 55 have no teeth at all.
• Which professions have the legal right to treat patients in what manner.  
• Long-term care/preventive care medicine vs. short-term care. (When discussing the ramifications of a dental therapist performing an extraction, Dr. Raymond Gist, the American Dental Association president, notes that: “If you have a person suffering from pain, that person has advanced disease,” said  “I would want that person to see a licensed dentist without delay.” Would an extraction necessarily prevent disease from spreading, or will the patient end up needing yet another extraction as disease spread?)

No one is arguing that patients shouldn’t receive care. But how this particular discussion plays out is an important reflection of a much wider national discussion.