July 15, 2007
Court rules in favor of Dental Health Aide Therapists
In a decision issued June 27, Superior Court Judge Mark Rindner rejected a request by the American Dental Association (ADA), the Alaska Dental Society and others, to stop the dental therapist program in rural Alaska.
The plaintiffs argued that dental health aid therapists (DHAT) working in rural Alaska should be licensed by the state to ensure quality care.
The defendants, including the Alaska Native Tribal Health Consortium (ANTHC) and eight practicing Dental Health Aide Therapists (DHATs), contended that federal law, which regulates DHATs as well as village health aides, supercedes the law requiring state licensure.
The ruling means the therapists, who have trained for two years and are supervised by licensed dentists, can continue operating in villages, according Valerie Davidson of the Alaska Native Tribal Health Consortium.
“The fact our local solution to a local problem is going to make a difference in oral health care delivery for Alaska Natives is really exciting,” she said. “It’s great to have validation from the court.”
YKHC employs two dental health aide therapists who work at the Aniak and Toksook Bay subregional clinics under the supervision of dentists in Bethel.
YKHC Dental Director Dr. Edwin Allgair said, “On behalf of our dedicated Dental Therapists, I am glad this legal misunderstanding with the Alaska Dental Society has been cleared up. I look forward to working with other confident and secure professionals to bring adequate oral health care access to rural Alaska.”
YKHC’s DHATS trained in New Zealand, where dental therapists have practiced successfully for years. Just this year, a similar training program was begun in Alaska. Future Alaska DHATs will spend a year training in Anchorage and another year on-site in Bethel.
Dr. Kathleen Roth, the president of the ADA, said the ruling is a disappointment. “Our only objective in this litigation has been to improve access to high-quality oral health care in remote areas of Alaska, to ensure that dental personnel providing this care are properly trained, and to maximize patient safety.
The plaintiffs’ suit claims DHATs are violating state law by practicing dentistry without a state license. ANTHC and other defendants say the DHATs work under the auspices of a federal program authorized by the same laws that regulate village health aides. The judge agreed that the federal law supercedes the state dental licensure law.
The court ruling says, “community health aides who perform some of the same functions as state-licensed physician assistants have been serving Alaska Natives in rural areas since the 1950s” and that the State Medical Board has recognized that these community health aides are exempt from state licensing requirements.
The judge said if dental therapists had to get a state dental license before lawfully providing treatment, they could not do the work required of them under federal law. “Requiring the dental procedures at issue in this case to be performed by state-licensed professionals thwarts the federal purpose of making those procedures immediately available to Alaska Natives through the health care services of federally-licensed paraprofessionals.