Dental therapists — a practical solution to expand access to dental care

Florida can no longer afford to ignore its oral health crisis.

Sixty-six of Florida’s 67 counties now have documented dental health professional shortage areas, meaning the county — in part or in whole — lacks enough dental professionals to serve its residents’ oral health needs. Nearly 6 million Floridians now live in what are essentially dental deserts with limited access to basic dental care.

The cost of this oral health crisis is staggering. On average, about $45 billion of lost work productivity per year is attributed to untreated oral health disease in the United States. As the third most populous state, Florida contributes significantly to this figure. Furthermore, Florida spent nearly $1 billion in 2024 — a sharp increase from previous years — to admit patients with preventable oral health conditions to hospital emergency departments.

Unfortunately, emergency departments cannot treat non-traumatic oral health problems and only provide temporary pain relief. It is the most expensive and least effective method of treating oral health issues.

Florida’s oral health crisis is too expensive to ignore, both in financial cost and human suffering. Policymakers can profoundly improve access by authorizing dental therapists to provide essential dental care services across the state.

Dental therapists are not new. In fact, they have been providing dental care for 100 years in more than 50 countries, in both public and private settings. They have been utilized for nearly 20 years in the U.S., where 15 states authorize dental therapists to practice. Overwhelmingly, published studies have found that dental therapists expand access to safe, high-quality care.

Dental therapists would work under the supervision of Florida-licensed dentists to provide basic dental care that many Floridians can’t get today: exams, fillings, and simple extractions. They graduate from an American Dental Association (ADA) Commission on Dental Accreditation educational program and even complete the same licensing exam as dentists for the procedures they perform.

The urgency for reform is reflected in hundreds of research papers and countless anecdotal personal stories, which prove that regular dental care improves overall health and quality of life. For example, good dental health lowers the risk of cardiovascular disease, respiratory infections, diabetes, and birth complications, among many other harmful conditions. For children, poor oral health can even be associated with developmental delays.

The single most impactful way legislators can improve access to dental care in Florida is to allow the market to determine the number and types of providers. Yet maximizing access requires ensuring Florida has enough dental providers and that the right types are well-distributed across the state.

Organized dentistry remains the primary opposition to implementing dental therapy, despite published evidence supporting its safety and cost-effectiveness. These fears are not based on data that unambiguously suggest that dental therapists are a key part of the solution to end Florida’s oral health crisis. As has been the case with other areas of medicine expanding scope and access, such as with physician assistants, this policy innovation would increase the number of qualified providers, improve the capacity of dentists currently practicing in the state, and encourage the development of new, highly skilled health care workers.

On the patient side, more Floridians would have access to quality dental care, adults and children from poorer and rural communities would be far more likely to seek care before worse health challenges arise, and Florida could again serve as a model for other states seeking practical, market-based health policy reforms.

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Doug Wheeler is the Director of the George Gibbs Center for Economic Prosperity at the James Madison Institute.