Massachusetts Dental Society President Dr. David Lustbader joined Boston Herald Radio’s “Morning Meeting” program yesterday to talk about two bills being debated on Beacon Hill that would have a sweeping impact on Bay State dentists.
Q: What is the logic behind the bill that could create an environment where someone who isn’t a full-blown dentist could be filling cavities? What are your concerns?
A: It’s hard to define the logic, quite frankly. But I guess the initial impetus was under the guise of increasing access to care.
Q: But wouldn’t that also potentially decrease the quality of care?
A: Potentially. Very much so.
Q: Wouldn’t we potentially see more mistakes from people who don’t have the proper training?
A: That’s correct. This bill not only includes restorations, it also includes extracting teeth basically unsupervised.
General supervision is a nebulous term, it can encompass as far as 150 or 200 miles away, which really doesn’t do the patient much good.
Q: The other side, they might argue that when it comes to doctors and aides and this new class of dental professionals, “these people do almost everything anyway. Why shouldn’t they be able to do this?”
A: If you look at the medical model as an example … physician assistants and nurse practitioners do exist on the medical side, they work under direct supervision, they are not performing surgery, they are assisting and they’re there essentially to assist.
They can’t expand care, they can do preventative care and all those things are probably good ideas to expand to the dental side.
But to do irreversible procedures with indirect supervision, to me, could potentially be extremely reckless, could be dangerous, could set up a second class of care for poorer individuals — which I don’t think anyone wants to see happen.
Q: When it comes to extracting a tooth and the nerves and everything that’s involved, if things go wrong, could that be deadly?
A: Yes. It takes 14 years to become an oral and maxillofacial surgeon. Under this bill, after three years post high school, you would potentially be able to take out teeth.
Q: How much training would be required?
A: Under this bill, it’s three years post high school. So under our bill, which I believe is a better model, it would be four years of college plus two years of a master’s degree, which is analogous to what a nurse practitioner does.
