Dentist groups oppose proposal to expand hygienists' duties
Post Date: Feb 10 2015

By James MacPherson - Associated Press
February 10, 2015
BISMARCK, N.D. (AP) _ A bipartisan proposal to allow some dental hygienists to perform certain procedures now done only by dentists drew opposition Tuesday from groups that represent and regulate dentistry in North Dakota, while supporters said the goal was to improve access to dental care statewide.
Bismarck Republican Sen. Dick Dever, the measure's primary sponsor, told the state Senate Human Services Committee that 40 percent of North Dakota counties have either one dentist, or none at all, hampering access to routine oral health care for thousands of residents.
``If this bill fails to pass, where are we going to be five or 10 years from now?'' Dever said.
The legislation would create new positions called advanced practice dental hygienists, who would be employed by dentists but could work outside the office to reach underserved populations in rural areas or on the state's five American Indian reservations.
The advanced hygienist, who would be allowed to perform procedures such as pulling teeth and filling cavities, would be supervised by a dentist, who could be linked by video to watch and counsel the mid-level practitioner.
The North Dakota Dental Association and the state Board of Dental Examiners, which licenses dentists and hygienists, oppose the idea.
Dr. Rob Lauf, a Mayville dentist and president of the dental board, said his group was not consulted on the legislation that he said lacks education and training requirements.
``I am concerned we would be conducting an experiment on our citizens by trying to implement this bill,'' said Dr. Carrie Orn, who operates a dental practice in Jamestown.
Williston GOP Sen. Brad Bekkedahl, the only dentist serving in the Legislature, called the bill ``a radical re-write'' of laws governing dentists that would allow ``providers with less training than dentists to perform irreversible dental surgical procedures.''
Rachelle Gustafson, president of the North Dakota Dental Hygienists Association, said advanced hygienists not only would be able to work in areas with few dentists, but also where those that do practice won't accept Medicaid.
``That's a serious problem and one that cannot be addressed by the number of dentists currently practicing in North Dakota,'' Gustafson said. ``More high-price providers for routine care won't make that care more affordable.''
Minnesota, Alaska and Maine have programs similar to the one proposed for North Dakota.
Dr. David Gesko, the dental director for a nonprofit health system in Bloomington, Minnesota, said many dentists also were opposed to the idea when it began in his state in 2009, but most have now grown to accept it.
``This is another tool in the toolbox that the government should allow dentists to use to expand their practices and increase access to care,'' Gesko said.
The committee took no action on the legislation, which will be debated later by the full Senate.

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