Vermont Oral Health Care for All Coalition

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Vermont becomes the fourth state to authorize dental therapists! Click here to learn more

About Us

The Vermont Oral Health Care for All Coalition’s mission is to build a statewide consumer voice for oral health care and raise public awareness of the need for greater access to affordable dental care. It is made up of organizations including consumer groups, children’s advocates, health providers, organized labor, senior advocates, health clinics and other organizations who work with Vermonters suffering from the lack of access to affordable dental care.

Oral health is central to overall health, yet tens of thousands of Vermonters do not have access to preventive or routine dental care. While the state has made great strides in extending affordable health care to low and middle-income Vermonters, lack of access to affordable oral health care for all our citizens is a long-neglected systemic issue.

The Coalition is working to address this systemic problem through giving Vermonters a voice in the care they receive, building awareness about the importance of oral health to overall health, and exploring innovative solutions to provide greater access to all Vermonters for the dental care they need.

Agenda

Expansion of programs serving low-income children and families

    • Getting Public Health Hygienists into WIC Clinics
    • Expanding the Tooth Tutor Program

Medicaid expansion

    • Include dentures in adult Medicaid coverage
    • Raise or remove the adult Medicaid dental cap of $510 per year

 

Accomplished agenda items:

The coalition successfully advocated for increasing access to care in the state by adding a new dental practitioner to the team to expand the reach of the dentist. This practitioner model is based on two different current models, both of which are proven methods of increasing access while providing safe, competent, and effective preventive and restorative dental care.

Full dental coverage for all pregnant women on Dr. Dynasaur: The coalition successfully advocated to give pregnant women on Dr. Dynasaur over the age of 18 the same benefits as pregnant women under 18 years so that all pregnant women and their children can begin early on the path to good oral health care.

Get Involved

There are many ways to get involved with our efforts to ensure that all Vermonters have access to dental care. You can share your story with us, like us on Facebook,  and follow us on Twitter. As we support the roll-out of dental therapy in Vermont, we welcome invitations to community meetings, health teams, etc. to explore how dental therapists can help your community improve access to oral health care for all!

 
 

Dental Therapy Information and Resources

Background

In 2016, Vermont became the third state government in the U.S. to authorize the licensing of dental therapists. Vermont’s law establishes a prerequisite that dental therapists be Vermont licensed dental hygienists. Dental therapists play a key role in increasing access to dental care and preventing emergency room visits for dental–related problems.

Definition

Dental Therapists (DTs) are mid–level practitioners licensed by the Board of Dental Examiners who serve as members of an oral health care team. They conduct oral evaluation and assessment, provide preventive and restorative dental care (including the non-surgical extraction of certain diseased teeth), treatment plan formulation, and more. The full scope of practice can be found in statute at 26 V.S.A. § 613.   DTs practice under the supervision of a licensed dentist, with the limits of their practice defined in a Collaborative Management Agreement (CMA). CMAs are detailed contracts that outline a DT’s scope of practice (up to the full scope authorized in statute), type of supervision (general or direct), referral protocols, and other conditions governing the DT’s practice. The full requirements for CMAs can be found in statute at 26 V.S.A. § 614.

Education, training and certification

Vermont state statute Title 26, Chapter 12, Subchapter 3a (26 V.S.A. § 611-617) defines specific educational, examination and practice requirements for licensed dental therapists. Vermont is the first state to require that dental therapists graduate from an education program accredited by the Commission on Dental Accreditation (CODA), the nationally-recognized accreditation body for dental education programs. CODA standards were adopted and implemented in 2016. The accreditation process is estimated to take 12-18 months, so there are no accredited programs yet in the United States. Vermont Technical College is developing a dental therapy program at their Williston campus. The anticipated start date for the program is 2019, with the first class graduating in 2020. There are two programs training dental therapists in Minnesota. Although they are not yet CODA accredited, their standards may be considered substantially equivalent by Vermont’s Board of Dental Examiners, allowing DTs trained at these institutions to apply for licensure by endorsement. Dental therapists from other jurisdictions interested in applying for licensure in Vermont should contact the Vermont Board of Dental Examiners.

Scope of practice

The law defines specific services that a dental therapist can perform. The full scope of practice can be found in statute at 26 V.S.A. § 613.

Supervision

Dental Therapists work under the direction of a Vermont licensed dentist through a collaborative management agreement (26 V.S.A. § 614). DTs may work under either direct supervision (supervising dentist is on site, but not necessarily in the room) or general supervision (supervising dentist is not on site). Information about collaborative management agreements and guidelines for drafting a collaborative management agreement is available on the ???. Upon completion of an approved course of study but prior to entering into a CMA, dental therapists must “complete 1,000 hours of direct patient care using dental therapy procedures under the direct supervision of a dentist” (26 V.S.A. § 614).

Billing and reimbursement

The Department of Vermont Health Access provides information on enrollment and reimbursement for dental therapists serving publicly-insured Vermonters (Dr. Dynasaur and Medicaid). Questions regarding coverage, payment and reimbursement for clients enrolled with a commercial insurance carrier should be directed to those specific organizations.