Most states ban dental therapists, blocking a proven model for expanding access

Dental therapists are mid-level providers — similar to physician assistants in medicine — who can perform routine procedures like fillings, extractions of baby teeth, and placing temporary crowns. They train in 2-3 years rather than the 8+ years required for a dentist, and they cost significantly less to employ. In Alaska, where dental therapists have practiced since 2005 in remote Native communities, they have dramatically improved access to care in areas where no dentist would practice. Yet as of 2024, only 14 states authorize dental therapists. The consequences of this restriction fall hardest on rural and low-income communities. There are vast dental health professional shortage areas across the United States where residents drive 60-100 miles to see a dentist. These communities do not need a full dental surgical suite; they need someone who can fill a cavity before it becomes a $3,000 root canal. Dental therapists are specifically trained for this role, and every peer-reviewed study of their work in Alaska and Minnesota shows outcomes equivalent to dentists for the procedures within their scope. The reason most states still ban dental therapists is direct, organized opposition from state dental associations. The ADA and its state chapters have spent millions lobbying against dental therapist legislation, arguing that only dentists should perform any dental procedure. This is a scope-of-practice turf war identical to battles physicians fought against nurse practitioners decades ago. The dental lobby is one of the largest healthcare contributors to state legislators. Until the political cost of blocking dental therapists exceeds the lobbying power of the dental establishment, most states will continue to ban a provider type that every evidence base supports.