Safety Net Care and Midlevel Dental Practitioners: A Case Study of the Portion of Care That Might Be Performed Under Various Setting and Scope-of-Practice Assumptions

Am J Public Health. 2015 Sep;105(9):1770-6. doi: 10.2105/AJPH.2015.302715. Epub 2015 Jul 16.


Objectives: We sought to determine the proportion of dental care provided at safety net-type clinics that might be performed by midlevel practitioners.

Methods: Data were obtained on 157,328 procedures performed in 2012 at the clinics associated with a Midwestern dental school. Based on procedure codes, we determined the overall proportion, as well as the proportion of visits and patients' care, that could have been performed by 3 types of practitioners.

Results: Overall, 48% to 66% of all procedures could have been performed by a midlevel dental practitioner. Nearly half of all visits, and roughly a third of all patients, could have been entirely cared for by a practitioner trained in prophylaxis and with evaluation capabilities. Such practitioners could handle roughly 80% of the visits at the community-based clinic and more than half of the visits at the hospital-based clinic.

Conclusions: A midlevel practitioner with training in prophylaxis has the potential to alleviate much of the burden on the dental safety net because much of the need among vulnerable populations falls well within their scope of practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Dental Auxiliaries*
  • Dental Hygienists*
  • Female
  • Humans
  • Insurance, Dental / economics
  • Male
  • Medicaid / economics
  • Organizational Case Studies
  • Public Health Dentistry / economics*
  • Safety-net Providers / economics*
  • Schools, Dental
  • Students, Dental*
  • United States
  • Workforce