Title	Studies Regarding Non-Reversible Procedures Completed by Dental Therapists Have Overall Shown to be Acceptable
Clinical Question	For patients in areas with limited access to dental care, is treatment provided by dental therapists an acceptable alternative?
Clinical Bottom Line	Studies regarding non-reversible procedures completed by dental therapists have overall proved to be acceptable. The reviews included in this study determine dental therapists to be competent in delivering care to patients as allowed by their DDS counterpart.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 23690358 Phillips/2013 Patients served by dental therapists in industrialized countries. Systematic review of non-randomized trials Key results This report explains a systematic review done on 23 studies concerning the competency of dental therapists in a handful of countries including the United States. The evidence found all but 2 studies proved the work done by dental therapists were considered acceptable. The text claimed hygienists or dental therapists, with proper training, could competently deliver non-reversible procedures to patients. One of the studies also shows two of three dental therapists “outperformed” their dentist leader in a preparation and restoration. 23865650 Mathu-Muju/2013 Children under the care of dental therapists contrasted to those under the US model of private practice. Case series Key results A summary of the dental literature “A Review of the Global Literature on Dental Therapists: In the Context of the Movement to Add Dental Therapists to the Oral Health Workforce in the United States” describes the disparities between the countries that offer alternative dental care treatment for children with limited access and that of the United States’ private practice model. The studies show countries with publicly funded, school based programs headed by dental therapists has a difference in caries free children by as much as 19.2%. The review notes a study done in Canada reveals the work done by dental therapists includes only 9% of cases which the work would be deemed unacceptable. 19853552 Nash/2009 Children with limited access to oral health care. Case series Key results This report focuses on the option to add dental therapists to the American health care providers to improve access to oral health care for children. It stresses the decline of the population ratio of dentists to citizens from the current 58/100,000 to 52.7/100,000 in the year 2020. Also the text states that the dental shortage areas in federally designated areas has increased from 792 in 1993 to 4091 in 2009. The research includes information regarding dental therapists who were trained in New Zealand but working in Alaska on their dental treatment performance and found it acceptable.
Evidence Search	"Dental therapists"[All Fields] AND "access to care"[All Fields]
Comments on The Evidence	Validity: The reviews include some evidence, including 5 randomized trials, in which dental therapists are able to provide limited care to those who have little access to oral health care. However, these studies do not include the specific procedures in which dental therapists are allowed. Perspective: Although these studies focus on the successes of dental therapists, they do not necessarily address the specific procedures. I believe more studies will need to be done regarding the summation of care dental therapists are allowed to provide before they may work in other parts of the United States.
Applicability	Dental therapists have proved their ability to produce acceptable work for procedures that they are allowed to complete. However, they are not trained as medical professionals but more as technicians. This could lead to problems such as missed diagnoses. More research may need to be done with dental therapists before they are allowed to practice in more places in the United States.
Specialty	(Public Health) (General Dentistry) (Dental Hygiene)
Keywords	Dental therapists, underserved areas
ID#	2646
Date of submission	03/25/2014
E-mail	colbyrichey89@gmail.com
Author	Colby Richey
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Suman Challa, BDS, MS
Faculty mentor e-mail	challas@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available