EDITORIAL: Dental drill-and-fill idea a bit hard to swallow - Cavities

EDITORIAL: Dental drill-and-fill idea a bit hard to swallow
September 17, 2008
RDH

Sep. 17--Let's say you live on the Iron Range or elsewhere in rural Minnesota. And let's say there isn't a dentist nearby. Would you settle for having your teeth drilled and filled by someone with a bachelor's degree in dentistry rather than a doctorate?

Don't answer right away because there isn't any such degree program, at least not in the United States. But Minnesota dental officials are mulling starting one, with the altruistic aim of bringing needed dental care to the Range and other underserved areas.

"That's been a struggle for us," Dr. Patrick Lloyd, the dean of the University of Minnesota School of Dentistry, told the News Tribune's editorial board this week during stops in the Arrowhead.

Currently, the U program has five dental students doing a rotation in Hibbing, and its entire 100-member student body is required to spend two one-month periods serving underserved communities. Yet after graduation, most opt for urban practices, leading the Legislature this spring to call for a solution to the rural dental drain.

One idea that has captured the attention of Lloyd and others is a four-year dental therapy program, whose graduates would be allowed to drill and fill all patients and pull teeth in children (but not adults). The profession exists in Canada and New Zealand, where Lloyd and a Minnesota dental care delegation visited in August, and the group will soon be off to England to see dental therapists in action there.

While on their world tour, however, they may want to ask if the problem couldn't be solved with some simple math; specifically, by increasing the number of students admitted to dental school.

Setting aside for a moment whether four years of college is good enough for someone to perform what Lloyd called "irreversible" procedures -- drilling and filling -- the most effective way to keep the dental therapists in underserved areas is to offer tuition forgiveness or other financial incentives (a la Dr. Fleischman's commitment to Alaska in the 1990s TV series "Northern Exposure.")

Couldn't similarly attractive programs be created for full-fledged dental students? And if there aren't enough applicants to serve the state, couldn't the U increase its admissions; how many rejected dental school applicants would say no if they got a follow-up acceptance call on the condition they practice in Tower-Soudan or Buhl?)

It's at least worth considering before embarking on an uncharted program, or an irreversible procedure.