AGD disputes findings of latest Kellogg survey

The Academy of General Dentistry (AGD) has spoken out against the phrasing of questions in a W.K. Kellogg Foundation survey, the results of which claim that the majority of Americans support new nondentist midlevel provider models to address access to care.

Among other things, the survey asked respondents if they would support or oppose "training licensed dental practitioners to provide preventive, routine dental care to people who are going without care."

"The manner in which the questions were posed may have caused some confusion among the public responding to the survey," stated Howard Gamble, DDS, president of AGD, in a press release. "Members of the public may not have been aware that the question was referring to supporting or opposing 'nondentist midlevel providers.' "

Midlevel providers do not have the same level of education as a dentist, Dr. Gamble added; they are nondentists with as little as two years of training after high school to perform clinical dental procedures that may be irreversible, on populations with the most complex health conditions, without the direct supervision of a dentist.

"Therefore, these midlevel providers could be putting the patient's oral and overall health at risk, and that is a concern to the AGD," he said.

The survey also found that a substantial number of Americans do not have health insurance, do not have a dental home, and cannot afford dental care. The AGD believes that dentists, hygienists, dental assistants, public organizations, and foundations must find a way to implement proven solutions to improve the oral health of the public, rather than create a new position entirely.

"Unfortunately, the W.K. Kellogg Foundation has chosen the path of presenting its unproven and likely dangerous political spin of using nondentists to treat those in greatest need as a viable low-cost and accessible alternative," said Joseph Battaglia, DMD, AGD Dental Practice Council chair. "The survey fails to mention that a dental degree provides the minimal competence to practice dentistry. It fails to mention that the breadth of education of a dentist results in judgment that is vitally important to provide for patient care, and that lack of this judgment will increase the likelihood of leaving the patient in worse health than he or she was in. When it comes to oral health, something is not always better than nothing."

The AGD voiced its support for other solutions, including student loan repayment programs targeted at serving the underserved; increases in community services, such as transportation and oral health education; improvements to Medicaid; additional volunteer services programs in impoverished regions, such as those offered by the AGD and AGD Foundation's Outreach Program; and a stronger public health infrastructure that focuses on establishing "dental homes" under the supervision of licensed dentists.

The AGD called on foundations like Kellogg to provide finances and support to implement the solutions.