Bill aims to expand dental access in rural N.D.
Post Date: Feb 05 2015

By Amy R. Sisk - The Bismarck Tribune
February 5, 2015
Several proposals to advance dental care in North Dakota are in the works, and lawmakers will hear one plan next week that encourages dental hygienists to meet the needs of rural residents.
Senate Bill 2354 would allow advanced practice dental hygienists to work in North Dakota. The measure, sponsored by Sen. Dick Dever, R-Bismarck, will come before the Senate Human Services Committee Tuesday.
Forty percent of North Dakota counties have only one dentist or none at all, said Rachelle Gustafson, president of the North Dakota Dental Hygienists’ Association.
“Even though the number of dentists has slowly increased in the state of North Dakota, this still is not enough to meet the needs of our state’s growing population,” she said Thursday at a press conference.
The bill aims to get more dental workers serving people who do not receive routine dental care, including rural residents, people on Indian reservations and Medicare and Medicaid patients, she said.
It would let dentists hire advanced practice dental hygienists. Dental hygienists in North Dakota currently handle preventative care, but mid-level practitioners, such as the ones this bill would allow, could perform simple procedures such as fillings and tooth extractions.
Dental hygienists would work under the supervision of dentists but could go off-site to treat people who might, otherwise, have a difficult time accessing services, she said. Hygienists may use video teledentistry to consult with dentists.
Minnesota allows advanced practice hygienists, and similar programs exist in Maine and Alaska.
Not everyone in the North Dakota dental community is on board with the idea. The measure faces opposition from dentists represented by the North Dakota Dental Association.
Executive director Brent Holman said there’s not enough evidence to show advanced practice dental hygienists are an effective way to address the demand for dental services.
He recommends the state pursue other avenues to reduce barriers to care.
“There’s really a long list of reasons people don’t go to the dentist,” he said.
The association has proposed a handful of ideas, including making use of grants through the North Dakota Dental Foundation and more training for dental assistants to alleviate the workforce shortage in western North Dakota.
Dentists face difficulties getting credentialed to work on Indian reservations, but they could get around this by contracting with local providers, he said.
Holman called SB2354 premature because North Dakota is not equipped to train advanced practice dental hygienists.
“Not having a school here would mean we have to rely on Minnesota for that,” he said.
The North Dakota Board of Dental Examiners would have to set education standards, Gustafson said. Supporters hope to partner with schools in Minnesota that could offer training in advanced dental therapy to hygienists interested in working in North Dakota.
Holman said the dental association is backing several other bills to improve access to dental care.
Senate Bill 2197 would expand the Seal! ND program that offers sealants to elementary school children. Another measure, Senate Bill 2205 would simplify a program for dentists to repay their school loans, which Holman said would help those practicing in rural areas or serving Medicaid patients.

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