Dental Therapists

Before a dental therapist and dentist can begin working together, they craft and sign a collaborative management agreement (CMA), which outlines what services the therapist can and cannot provide to patients and the dentist’s professional expectations for the therapist. Some states require that CMAs must be filed with the Board of Dentistry before the dental therapist/advanced dental therapist can begin caring together for patients.

Supervision rules and the types of duties that therapists can perform vary by state and employment setting. In Minnesota, for example, there are four levels of allied dental professional (ADP) supervision by dentists:

• personal supervision: the dentist personally treats the patient, but is assisted by ADPs who concurrently perform support procedures
• direct supervision: the dentist authorizes the ADP to perform the procedure, and evaluates his or her performance before the patient is released from treatment
• indirect supervision: the dentist authorizes the procedure and remains in the office while the ADP performs the procedure, but does not review his or her work
• general supervision: the dentist authorizes the tasks or procedures completed by the ADP, but does not have to be in the office or on the premises while the work is done

The Minnesota Dental Therapy Association (MDTA) does not provide examples of approved services for all four categories, but it does provide a summary of approved services (unless restricted or prohibited in the CMA) in the general supervision and indirect supervision categories.

According to the MDTA, some of the services that dental therapists are authorized to provide in the general supervision category include completing preliminary charting of the oral cavity of patients at the beginning of an examination; making radiographs; applying topical preventive or prophylactic agents, including fluoride varnishes and pit and fissure sealants; conducting pulp vitality testing; applying desensitizing medication or resin; fabricating athletic mouthguards; performing dressing changes; reimplanting teeth; administering local anesthetic and nitrous oxide; and providing oral health instruction and disease prevention education.

In the indirect supervision category, dental therapists in Minnesota can place temporary crowns, extract primary teeth, remove sutures, repair defective prosthetic devices, conduct pulpotomies on primary teeth, and conduct brush biopsies, among other duties.

In some states, licensed dental therapists are authorized to dispense and administer certain drugs. In Minnesota, for example, therapists are permitted to dispense and administer analgesics, anti-inflammatories, and antibiotics.

Dental therapy is such a young profession in the United States. The services that a therapist can provide vary significantly by state. If you live in a state in which therapists are licensed to practice, check with your state’s regulatory board to learn what services they are authorized to provide.