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Dental care an urgent need across all of New Hampshire

At one time in my 40-year nursing career, doctors were the only ones who could offer primary health care and complete medical procedures. Today, nurse practitioners and physician’s assistants provide routine care in doctor’s offices, community health centers, clinics, and hospitals. When changes like these were first proposed, there was a strong opposition and outcry from the medical profession.

But these professionals have proven themselves, providing good quality, efficient care that expands access to health care. And doctors agree. A similar care delivery model can improve our state’s oral health as well.

I have sponsored legislation that would authorize a new type of dental provider, called a Dental Hygiene Practitioner. I believe it will help close one of the gaps in our oral health care delivery system that bars its doors to many of our most vulnerable: children, seniors, and others with physical or financial barriers to routine dental care.

I am pleased that more than 20 diverse groups across the state support this legislation. They represent the young and the old, health care practitioners, businesses and people who are disabled. These groups know firsthand that too many are not getting the oral health care they need and that it is not good for our citizens, businesses or our state.

The organization representing dentists, however, has attacked the legislation and said it is unnecessary. Yet, one of the top reasons people seek hospital emergency room assistance in New Hampshire is for oral health-related complications. For the past ten years almost every community needs assessment ranks access to oral health as one of the top five needs. And, a study by the NH Hospital Association shows that two-thirds of NH hospitals cite access to care as the primary health need in their community – and rated availability of dental/oral health care as the top concern.

Some may say access to dental care is a regional issue and that it only impacts those in the North Country or the western part of our state. I strongly disagree as do many statewide organizations supporting this bill. The issue of changing the dental delivery system is an everywhere problem. I have met and talked with Dental Clinics, Harbor Homes of Nashua and Community Health Centers.

They all say the need exists. So, I submit, let’s solve this access problem the New Hampshire way, and empower dentists with the opportunity to employ a mid-level practitioner similar to those already practicing in two states and many countries. Currently, Maine, Vermont, Massachusetts, and 10 other states are considering similar legislation.

To be clear, this is not a legislative mandate being forced on an industry. And, this is not a silver bullet. But if the Dental Hygiene Association of NH knows it will increase access and create jobs, if EngAging NH sees that this will help seniors in our state and the Business and Industry Association understands it important to promoting a strong workforce, I believe we owe it to them and to the people who need care, to pass this legislation. Rest assured, no one is ordering a dentist to incorporate a new provider into his or her practice. The market can dictate this provider. If a dentist does not want a dental hygiene practitioner than they don’t have to hire one.

The legislation that is currently proposed, SB 193, clearly requires that the dentist supervise and control the scope of practice within our their own parameters.

As our health care delivery system changes and the role of practitioners change along with it, it should be our goal to provide more care in a cost effective and safe manner. Yes, the State of New Hampshire has made great strides in oral health care, and I know that many dentists and practitioners volunteer and give free and reduced care, but there are still too many in our state who do not get the care they need. Everyone in the Granite State deserves an opportunity for a bright and confident smile.

Peggy Gilmore, a Democrat, represents Senate District 12, which includes New Ipswich, Rindge, Greenville and Mason.

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