A House panel has advanced a bill that would add a mid-level dental provider in Florida, setting off a debate over whether the new role would expand access to care or allow irreversible procedures by non-dentists.
HB 363, sponsored by Republican Rep. Linda Chaney of St. Pete Beach, would create a dental therapist position to work between hygienists and dentists on the dental care team.
Chaney told the House Health Professions and Programs Subcommittee that the therapists would provide preventive and routine restorative care such as filling cavities, placing temporary crowns and extracting “badly diseased or lose teeth” under collaborative agreements with supervising dentists.
She and other supporters argue that the expanded dental care team would grow access to dental care. Opponents warn about the need for the more experienced dentist’s hands on the wheel in case a simple extraction is not so simple.
The subcommittee approved the bill 13 to 3. It is the third time Chaney has submitted the measure for approval from the Legislature.
“Sixty-six of our 67 counties are federally designated as Health Professional Shortage Areas (HPSA’s),” Chaney said. “Fifty-nine million Floridians live in these 274 dental HPSA’s. … The need is significant.”
Chaney explained that the bill is driven by a statewide shortage of about 1,300 dentists, and that 66 of 67 counties are federally designated health professional shortage areas. She said dental therapy programs already operate in other states and that colleges in Florida are prepared to launch tailor made programs for the position.
Chaney said therapists could practice only within their training and licensure, and under a collaborative management agreement that dentists can mold.
“The goal of the bill is to increase access, reduce costs, allow dentists to do more advanced procedures and see more patients,” she said.
Catherine Cabanzon, a licensed dental hygienist and former Chair of the Florida Board of Dentistry, said she has seen access challenges across the state.
Cabanzon pushed back on concerns about training, saying dental therapy programs are developed by the same accrediting commission that oversees dental and dental hygiene standards. She said that therapists take the same exam as dentists for the procedures they perform.
“We have been going through this cycle over and over and over again, it is time for us to look at different tools and the tool box,” Cabanzon said. “There’s not one answer to this problem. There’s multiple answers to it.”
Opponents urged lawmakers to reject the bill, arguing that irreversible procedures should remain in the hands of fully trained dentists. Retired Navy and general dentist Merlin Ohmer, who served 30 years on active duty, said that in his experience, even seemingly simple extractions can become complicated.
“I can tell you there’s no such thing as a simple extraction until the tooth is out and laying on the table,” he said. “You don’t know, and you can’t tell, until the procedure is complete.”
Chaney said dentists would retain authority to decide what procedures therapists can perform, and that their licenses remain on the line.
She argues the bill fixes a specific problem with access to care in Florida: that low Medicaid participation leaves many people without options.
“The dentist’s license is going to be on the line, that their therapist is performing procedures that they are comfortable with,” Chaney said. “Only 18%, or 1 in 5 dentists, take Medicaid. So there’s a whole lot of patients out there that don’t have access to dental care, they end up in the ER.”
The bill has one more committee stop in front of the House Health & Human Services Committee.