patients. They both are finding it difficult to impossible to fill their staffing needs due to a decrease in providers in the hygiene workforce. Further investiga- tion shows them there are fewer of these providers graduating because hygiene programs have been cut or eliminated across the state.
These “imagination” situations are real. They are happening more and more ev- ery day. Patients’ needs are not being met in all dental settings and practice types and in all parts of the state—rural and metro. Wouldn’t it be great if there was another dental care provider available who could work with the current dental team to help provide treatment to those patients in the hygiene area who are requiring valuable treatment time? How valuable would it be to have someone who could help treat those patients with healthy medical histories and little to no periodontal issues?
These are questions that several dental leaders have been working on for years. They have been diligently trying to find a way to address the needs that dentists have been telling them about for a long time. The Missouri Office of Dental Health has been looking at this and deemed it an urgent need for the health of the public. The Missouri Director of Oral Health, Dr. Jackie Miller, went be- fore the Missouri Dental Board in April to make a plea to allow for a pilot project to study an Oral Preventive Assistant Ex- panded Functions Dental Assistant (OPA EFDA). After a long discussion, the MDB approved allowing for a pilot project.
What would an OPA EFDA do? OPAs would treat only patients who are healthy or who have reversible gum in- flammation, not patients with advanced gum infections. They would be allowed to scale supragingival calculus, polish teeth and give oral hygiene instructions. OPAs would work under direct supervi- sion of a dentist or hygienist.
This was not something that was just pulled out of the air and thrown out as a fly by night idea. The countless hours
spent by previous and present leaders in the Missouri Office of Dental Health, have not gone unnoticed. Many leaders and staff of the MDA have worked more than just overtime over the last several years trying to come up with solutions to deal with the issues at hand. All dental providers in the state of Missouri owe a depth of gratitude to these individuals who have selflessly worked to offer solu- tions to help the public receive the care they deserve.
The solution is not complete or done at this point. Only the approval of a pilot project has occurred. Curriculum must be and is being formulated for the project. Sites for the project are being identified, clinical and testing protocols are being developed. In short, the work is just beginning for this project, but those who are involved know the urgency of the need for knowledge of what the re- sults will show at the end of the project. For this project to be deemed a positive move in the dental workforce, it will have to show those who do it are trained properly, it will have to show the dentist (or hygienist) is in direct supervision of the EFDA provider, and it will have to show the new provider can be trained properly to deliver this treatment safely and efficiently to the patient.
To say this is happening without any controversy would be a stretch of the truth. As with any dental issue, there are always dental groups that can find posi- tive and negative with any situation. The MDA has provided a very thorough set of information on this subject at modental. org/opapilot. This information covers every aspect of what has happened, what is planned and detailed information about this issue and project. I would encourage you to take time to read it all and if you believe in it as many others do, send a letter or email to support to the Missouri Dental Board.
Contact Dr. Wyckoff at editor@
modental.org.
MY VIEW
There Is Work To Do
by VICKI WILBERS, MDA EXECUTIVE DIRECTOR
E
very month the ADA holds a “Power of Three” call with all the states to update us on various topics and initiatives. These started during the COVID pandemic and have contin- ued to keep staff and leaders informed. Part of each call includes an update from the ADA Health Policy Institute (HPI). As a result of the pandemic, HPI began—and has continued—sur- veying the “Economic Outlook and Emerging Issues in Dentistry” as a way to track dentists’ perspectives on a variety of issues, including workforce.
In the most recent call the end of June, the HPI stats continued to show dentists’ challenges in recruiting dental team members. As you can see in the graph image (from the slides presented in that June call), more dentists are report- ing recruitment of dental hygienists is very or extremely challenging in July 2023 compared to a year ago (2022, 92.8 percent versus 2023, 94.5 percent). It has fallen slightly for dental assistants (2022, 84 percent versus 2023, 83.7 percent). Workforce challenges are still very relevant and present; and HPI stated, as we all likely know, this is not something we can im- mediately fix; it will likely be several years before it may show improvements.
MDA’s involvement with the workforce shortag- es is ongoing. With the Office of Dental Health’s (ODH) Oral Preventive Assistance Expanded Function Dental Assistant (OPA EFDA) pilot project, the MDA has hired a dentist, Dr. Drue Barton, to work on the curriculum development
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