A dental therapist receives specialized training in treating children's teeth and oral hygiene. Local dental regulations determine the duties therapists are able to perform. Typically, therapists under the prescription of a dentist are licensed to examine children's teeth, administer restricted techniques of local anesthesia, take radiographs, provide sealants, scaling and cleaning in children. Also restoring primary teeth and vital pulp treatments such as pulpotomies.
Local dental regulations are constantly changing to include extended duties and exemptions for dental therapists.
In the UK a dental therapist working from a prescribed treatment plan can treat children and adults, with direct restorations, periodontal and oral hygiene treatment and extraction of deciduous teeth. They can also place pre-formed stainless steel crowns on deciduous teeth. They can apply medicaments listed by the General Dental Council and administer local anaesthetic by infiltration, intrapapillary, intraligamentary and inferior block techniques. Dental therapists can work independently and outwith the supervision of a dentist. Training is usually by dual diploma in dental hygiene and dental therapy but a few dental schools offer full degree training in combined hygiene/therapy. Therapists trained in the UK can work in the NHS and privately or work in the hospital and community service.
The AP/Atlanta Journal-Constitution examined concerns about the use of dental health aid therapists, who do not have state dental licenses, to provide dental care in rural areas, part of a debate over "whether the standards of medical training are being sacrificed in the name of bringing health care to underserved areas." According to the AP/Journal-Constitution, the American Dental Association and some lawmakers maintain that dental therapists do not have proper training and might cause permanent damage to some patients, and other lawmakers "see the benefits of bringing dental therapists to rural areas -- just not in their states." Sen. Tom Coburn (R-Okla.) had proposed an amendment under which dental therapists could not perform procedures that might cause "irreversible damage," but the Senate Indian Affairs Committee last month rejected the measure. "It starts us down a course to give lesser care to those who are dependent on us," he said.
ADA President Robert Brandjord said that dental therapists should focus on prevention because they might not have adequate training to address serious complications in patients with medical conditions such as diabetes or heart problems. He added, "The ability to diagnose things is the key to it. The background to do that comes with greater ability and experience." However, Myra Munson, an attorney for the Alaska Native Tribal Health Consortium, said that ADA overstates the risks. "It is easy for people who have gone through a lot of education to say that only people that have had a similar level of education could do what they do," Munson said.
