As a regular subscriber to this newspaper, I’ve seen a lot of discussion about a bill pending in the Maine Legislature that would create a new level of dental provider. Basically, the proposal would allow dental hygienists — with additional minimal (and undefined) training — to expand their scope of practice to include administering anesthesia, drilling and filling cavities and extracting teeth. That part is scary enough, but also throughout this debate no one has presented how and where these dental hygiene therapists will be educated. No one is talking about the length of time it might take for us to see any impact on access if the Legislature passes this bill.

From an educational standpoint, the process of creating a new level of practice — without defining what the curriculum contains or even where the instruction will be conducted — is not sound education practice. As a retired Maine college professor, with more than 40 years of teaching experience, this proposal is preposterous.

In Minnesota, one of the two states in the country that employs midlevel dental providers, legislation was passed in 2009 and the first class of dental therapists entered the University of Minnesota in 2011. The class had 26 students. The class of 2012 has 9 students; 8 are master’s level students and only 1 is a bachelors level student. UMN is NOT accepting bachelor track applications for the fall of 2013.

Keep in mind, the Minnesota statute is far more restrictive than what is before Maine’s Legislature. In that state, a masters level therapist must have 2,000 hours of clinical practice and pass an exam before being able to work under the general supervision of a dentist. We aren’t even close to that level of training here. In fact, as stated above, the curriculum is yet to be defined.

Good education programs are focused on goals, objectives, skills and competencies. These are prerequisites to forming any successful training program. Discussions of these important pieces have been completely missing from the debate — and the proposed legislation is devoid of them.

Here’s another problem: Where will Maine hygienists and others interested in becoming dental therapists be going for their education and training? Will they be expected to commute to Minnesota? Resident tuition and fees for the program at UMN is $68,000 and for non-residents it’s $78,000.


Are the proponents of this bill advocating a new program of study, as yet to be accredited by the Commission on Dental Accreditation, at the University of Maine system or the community college system? This is a large undertaking. Equipping and hiring dentists to teach and oversee this sort of program could cost as much as one million dollars. Are Maine taxpayers ready to subsidize this idea? Three years ago, in 2010, voters approved a five million dollar dental care bond. In addition to the concerns about financial resources is the unknown timeline. Even if the Board of Dental Examiners were able to adopt rule setting requirements for a dental hygiene therapy education program by January 2014, it is highly unlikely that any program at a Maine College or University could be in place before the fall semester of 2014. Optimistic at best, we’d see the first class graduate in 2016.

At the same time, in 2016, the University of New England’s College of Dental Medicine anticipates their 4th year student externs will be providing comprehensive oral health care to children and adults (20,000 – 25,000 patient care visits annually) throughout rural Maine under the close supervision of clinical faculty. Additionally, students in the Portland clinic will provide approximately 12,000-15,000 patient care visits annually.

It seems to me we should give our new dental school the opportunity it deserves. We’ve already spent those resources and followed the proper process to create a well-planned program of study – a program focused on goals, objectives, skills, and competencies. At the very least we should pause for CODA accreditation standards and gather data on whether the presence of dental therapists creates results in other states. LD 1230 represents a hasty decision not backed up by research and planning. The new dental school will yield almost immediate, measurable results. It’s the right choice for Maine.

Gail Schade is a retired college professor who taught at Thomas College and Kennebec Valley Community College during her 40-year teaching career. She lives in Hallowell.0

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