Expanding Children’s Access to Dental Care

How Minnesota Secured the First State Law of Its Kind

In May 2009, the Minnesota legislature became the first in the nation to approve the licensing of dental therapists — the dental equivalent of a nurse practitioner. A dental therapist is licensed to perform a specific scope of duties, such as filling cavities and extracting teeth.

This new law has not gone unnoticed. Policy makers in other states are viewing it as one of several potential solutions to the lack of access to dental care for millions of Americans, particularly the poor and uninsured. So how did Minnesota become the first state to pass such progressive and vital legislation? 

How it all started

From 1993 to 2000, Minnesota suffered the greatest percentage decline of all 50 states in the dentist-to-population ratio. At its lowest, the ratio was only one dentist per 1,670 residents. Dr. Colleen Brickle, an oral health educator and dean of Normandale Community College, spent a yearlong sabbatical researching dental care workforce issues in an attempt to address this growing issue. Her research confirmed her suspicions; thousands of Minnesotans did not have access to a dental provider, due to geography, low-income status or other factors. Given the shortage of dentists, she realized that part of the solution to this access problem was the creation of new types of practitioners.

The case for Dental Therapists

Aided by the work of a state health care reform commission, Minnesota passed a law allowing for the creation of two new types of licensed oral health professionals: a dental therapist who works with a dentist on-site and an advanced dental therapist who works under a collaborative practice agreement with an off-site dentist. Although the legislation did meet substantial opposition, Minnesota advocates were ready and built a broad coalition of persistent lawmakers, public health dentists, hospitals, health care providers, oral health educators and nonprofit groups, including The Pew Center on the States, to help with the case. After two years of lobbying, addressing misconceptions, and pure perseverance, the law passed in 2009.

How do I bring Dental Therapists to my state?

Minnesota's journey to licensing dental therapists can provide valuable lessons to other states looking to expand access to oral health care. Here are eight lessons from Minnesota: