Legislature could ease state’s dental shortage

New Hampshire faces a crisis in dental care, and SB 193 can help fix it


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Many New Hampshire families are looking forward to securing dental coverage for their kids under the health care reform law.

But there’s a big difference between having coverage and having care. Unless our Legislature does more to expand the number of people who can provide dental services, this coverage opportunity will be an empty promise.

Right now, nearly 29,000 residents are living in an area with a dentist shortage. In other words, the children who get dental insurance will be entering a fragmented system – one that lacks enough practitioners to meet our state’s oral health needs.

Unfortunately, this dentist shortage will worsen with time until our Legislature acts. Just a few years ago, an American Dental Association survey found that 43 percent of New Hampshire’s dentists are over age 55.

Let’s examine what happens when children can’t access dental care. Recent research has linked children’s dental problems to missing school and lower grades. That’s because tooth decay is the most common childhood disease – five times more than asthma. And when cavities don’t get fixed, they can lead to more serious infections.

Those who lack insurance or cannot find a dentist are more likely to show up in emergency rooms, the most expensive place to get treated.

Our state took a good first step to expand our dental health providers last year by passing a law that allows certified public health hygienists to conduct dental X-rays and place temporary fillings in schools and other public settings. But we need to do more.

Sen. Peggy Gilmour, D-Hollis, has sponsored an innovative bill, Senate Bill 193, to help address this problem.

It has been tested in other rural states. Minnesota and Alaska use mid-level dental therapists to expand the reach of the dental team. These individuals are trained and licensed to perform some of the most routine services only being offered by dentists, such as oral exams, cleaning teeth and filling cavities.

They work under the supervision of a dentist, but can work remotely in rural areas where dentists do not have offices.

Think of it this way: Decades ago, when you went to your yearly checkup, it was just a doctor and a nurse. Now there’s a range of providers, such as physician assistants and nurse practitioners, who play different roles to meet our medical needs.

Adding a mid-level oral health practitioner to the dental team would strengthen it and help expand care, just like the medical providers we rely on today.

Although the New Hampshire Dental Association opposes this bill, some dentists are open to this approach, realizing that having another member of the team could help them serve more patients with quality patient care.

More needs to be done to meet the growing demand in New Hampshire. All children should have access to oral health services, and adding another provider to the dental team will help us get there.

Ellen Fineberg is executive director of the Children’s Alliance of New Hampshire.

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