House passes bill to create dental therapist position despite Democrats’ warnings

The House has passed a bill to create a new mid-level job of “dental therapists” in between dental hygienists and dentists.

With a partisan vote of 80-29, Republicans applauded the bill (HB 363) for helping fix Florida’s dentist shortage, while Democrats warned that patients’ health could be at risk.

The shortage is acute in some regions. Dixie and Gilchrist counties have zero licensed dentists, while other counties have a ratio of only about 80 dentists per 100,000 residents, a House staff bill analysis said.

“This bill will help fill the gap in a lack of about 1,300 dentists in the state of Florida,” said Rep. Linda Chaney, a St. Pete Beach Republican sponsoring the bill. “That’s 5.9 million Floridians living in these 274 dental HPSA (health professional shortage areas).”

But Democrats said the bill clears the way for 18-year-olds with less training to do extractions and give anesthesia in dental offices.

Rep. Daryl Campbell said he was “deeply concerned” about the bill and called it “just bad policy.”

“What kind of care do we believe underserved communities deserve? Do we want kids with GEDs performing complex surgeries?” the Fort Lauderdale Democrat asked during debate on the House floor. “Or do we want qualified professionals doing jobs only they are qualified for?”

Campbell urged lawmakers to find better solutions to fix the dentist shortage, such as expanding loan repayment programs, increasing Medicaid reimbursement rates, supporting residency pipelines, and adding new incentives for dentists to practice in underserved areas.

“The answer to a problem of access is not to lower standards,” Campbell said.

But Chaney defended her bill, pointing to the fact that the new mid-level dental therapists would be licensed and regulated by the Department of Health (DOH) and the Board of Dentistry. 

“The state of Florida is not licensing people who are going to mess around in your mouth and are untrained,” Chaney argued.

In Florida, 3,000 people landed in the hospital for life-threatening dental infections in one year, while another 120,000 flooded the state’s emergency rooms because of teeth-related issues, Chaney said.

“This resulted in hospital costs of half a billion dollars,” Chaney said.

No Senate companion bill has been filed, making the path in the upper chamber unclear.

Under the House bill, dental therapists would be allowed to administer local anesthetics and nitrous oxide, as well as conduct nonsurgical extractions on some people’s teeth, “except for the extraction of a tooth that is unerupted, impacted, or fractured or that needs to be sectioned for removal,” the bill says. 

To give anesthesia under the dentist’s supervision, the dentist therapist must have first completed an anesthesia administration course and received a DOH certificate on basic or advanced cardiac life support.

Other dental therapists’ tasks could be cementing temporary crowns, pre-sizing orthodontic bands, putting on bleach, removing rubber dams, making impressions and more.

To become a dental therapist, a person must be at least 18 years old, have a clean criminal background and graduate from dental therapy school or a college accredited by the American Dental Association Commission on Dental Accreditation. They must also complete a dental therapy practical or clinical exam from the American Board of Dental Examiners within three attempts, as well as pass a written test on dental therapy rules.

DOH’s new licensing and regulation requirements for dental therapists would cost the state $240,634 — with $123,105 of that being recurring costs, according to the House staff bill analysis.

HB 363 would also expand Medicaid reimbursement for dental providers who work in mobile dental clinics.