NH reconsiders dental therapist legislation

New Hampshire is making another effort to establish a legally defined role for dental therapists, according to a report by New Hampshire Public Radio.

SB 193-FN, sponsored by state Sen. Peggy Gilmour (D-District 12), would allow dental therapists to perform a host of procedures under the supervision of a currently licensed dentist, following appropriate training.

Under the proposed bill, the permissible procedures would include the following:

  • Mechanical polishing
  • Applying fluoride varnishes and other preventive or prophylactic agents
  • Pulp vitality testing
  • Application of desensitizing medication or resin
  • Placement of temporary restorations, interim therapeutic restorations, temporary crowns, and recementing permanent crowns
  • Tooth reimplantation and stabilization
  • Administration of local anesthetic
  • Administration of nitrous oxide analgesia
  • Oral evaluation and assessment of dental disease
  • Formulation of an individualized treatment plan, including services within the dental therapist scope of practice and referral for services outside of the dental therapist scope of practice
  • Extractions of primary teeth and nonsurgical extractions of permanent teeth. They would not be permitted to extract a tooth that is unerupted, impacted, fractured, or needs to be sectioned for removal
  • Cavity preparation
  • Repair of prosthetic devices

The bill maintains that the need for dental therapists is being driven by access-to-care issues: "In New Hampshire, the distribution of dentists and the current dental workforce lacks the capacity to meet the needs of the underserved. ... Dental therapists are a vital, best practice workforce approach to addressing oral health access challenges for underserved populations and regions."

The bill is opposed by the New Hampshire Dental Society on the grounds that dental therapists would not be adequately trained for a number of nonreversible procedures, the article noted. Education, water fluoridation, and transportation efforts would better address the problem, according to the society.

New Hampshire lawmakers passed SB 284 last year, but the procedures it permitted were scaled back significantly before it was voted on. Neighboring states Maine and Vermont also have introduced bills that would outline a role for dental therapists.

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