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January 31, 2025
Dental therapy is expanding as more states authorize dental therapists to practice. But there are still a lot of questions when it comes to dental therapists’ capabilities, employment, and education.
During a recent CareQuest Institute webinar, “Dental Therapy: Examining the Misconceptions and Opportunities,” panelists discussed the current legislative landscape and scope of practice for dental therapists in the US. They also set the record straight on common misconceptions about dental therapy and evaluated the potential impact of dental therapists on improving patient outcomes and expanding care in underserved communities.
“Very impressive speakers that have such passion about dental therapy,” noted an attendee after the webinar.
Community Catalyst Dental Therapy Senior Project Manager Laura Brannon and Executive Director Sarah Wovcha, JD, MPH, of Children’s Dental Services in Minneapolis, Minnesota, presented to approximately 700 learners from the oral health community.
Below, we’ve provided an edited summary of the questions and answers about dental therapy.
The Capabilities of Dental Therapists
- Are there any states that allow credentialed dental therapists to open their own practices?
Yes, kind of. All states require dental therapists to work under the supervision of a dentist.
Colorado does let dental hygienists and dental therapists own their own practices, but therapists still have to work under the supervision of the dentist.
- What is the supervision of a dental therapist? You mentioned dental therapy in emergency rooms; is the supervision medical, then? A dentist won’t be supervising in an emergency or medical setting.
Dental therapists have to work under the supervision of a dentist but can work under general supervision via a collaborative agreement without the dentist on-site or without the dentist examining the patient first.
Can dental therapists write a prescription? Can they do anesthesia? Can they drill and fill? Can they diagnose?
They can administer and dispense, but generally, they cannot prescribe. There have been some questions asking if dental therapists can prescribe topical fluoride or something like that. It might be a really good idea to add that into the scope, but historically they have not been able to. Yes, they can give local anesthesia. Yes, they can prepare and place fillings.Most states don’t use the word diagnose. Dental therapists can do an exam and create a treatment plan. For political reasons, most states do not use the word diagnosis.
In Minnesota [where Wovcha works], the language of the law says that dental therapists can do a full comprehensive exam. However, when it came to slicing and dicing through the whole legislative rulemaking process, dental therapists ended up unable to be reimbursed for more than a limited exam. But they’re still able to do one.
What Employment Looks Like for Dental Therapists
- Do you know roughly how much a dental therapist is paid?
It varies by state and practice setting, but generally about one-third to one-half of what dentists make in that same setting.
- How do you see dental therapists impacting employment opportunities for dental hygienists and dentists? Are they a threat to those professions?
I don’t think so. Fewer than half the people in the US can get dental care every year. We have so many people in this country who need care. We have a massive shortage of hygienists and dental assistants right now. We need all the providers we can get, and I don’t see that changing.
Dental therapists can help dental practices be more effective and make more money. For private practices, that is more profit. For nonprofit clinics, that is more money that is going back into patient care, which means more patients getting care.
Training and Education to Become a Dental Therapist
- What exactly are the education requirements for dental therapists?
Most states just require completion of a Commission on Dental Accreditation (CODA) program, but some do require that dental therapists hold a specific degree (BS or MS) or a dental hygiene degree.
- To become a dental therapist, do you have to go to undergraduate school prior to dental therapy school, or is it a total of three years?
Requirements vary by state and program, but the national standards only require a program of a minimum of three academic years.
- What are continuing education requirements for dental therapists? Is there a recertification requirement?
It varies by state but is generally a similar requirement to the state’s other dental professions.
- Are there bridges from dental hygiene to dental therapy, or from expanded function dental assistance to dental therapy? If you are already either a dental hygienist or an expanded function dental assistant, will any of that education that you received count toward the dental therapy program?
There are bridge programs for dental hygiene to dental therapy. The accreditation allows programs to give advanced standing. It’s up to the program to decide how they want to do that.
Minnesota has been the leader in showing how to do that for dental hygienists. At this point, I think all the programs either do dual training or advanced standing in Minnesota. This varies by state. It’s not required by the national accreditation standard. Some states require dual licensure. Most don’t. But I think it’s actually an amazing option because we know so many dental assistants and dental hygienists have left the workforce in the last couple of years — and most of them leave because they don’t feel like there’s an opportunity for advancement. So, this is an opportunity for dental hygienists to come back and learn some more skills.
Right now, there aren’t any programs that offer advanced standing for dental assistants, but we’re hoping those will be developed.
- Do dental therapists have to pass a board exam that is limited by each state that allows dental therapy?
Most states require a board exam. CDCA-WREB-CITA and CRDTS both offer dental therapy exams; which one is required varies by state.
Moving Forward to Advance Dental Therapy
- What can we do to get dental therapy approved in our state?
Gather your friends, call your legislators, get over to the [state capitol building] often, tell stories, and give Children’s Dental Services a call. We’re happy to help testify. You can also go to dentaltherapy.org, the National Partnership for Dental Therapy. We have a ton of great resources.
I really think that dental therapists are like nurse practitioners, and they are the wave of the future. It makes public health sense and economic sense. Boots-on-the-ground advocacy can get us there — and the incredible resources that we have from Community Catalyst, CareQuest Institute, and others.
Editor’s note: You can view the full webinar, including the Q&A, in the CareQuest Institute webinar library.