Comment: Allowing dental therapists would improve kids’ care

By Ruth Kagi / For The Herald

Children cannot learn and thrive if they aren’t healthy. Washington’s legislators recognized this fundamental fact when they passed the Children’s Health Insurance Program more than a decade ago, and when they established a comprehensive health care program for foster and adoptive children and youth.

But one critically important gap still exists in children’s health care: dental care.

I served for 20 years in the legislature working to create real changes to improve the lives of children and families in our state. We made tremendous progress in addressing children’s mental health, requiring early health screenings for children, and creating a new department specifically focused on the safety and well-being of children, youth and families.

During my time in the legislature, I supported a bill to improve children’s access to dental care that was brought to session every year for the last 10 years, but it has not passed. This bill would expand dental therapy for children across the state, but it has been consistently blocked by the Washington State Dental Association despite solid evidence of its success in creating better access to dental care, especially for low-income children.

Dental therapists are a common-sense solution to plug a major gap in Washington state’s access to high-quality dental care. Dental therapists can provide preventive and restorative care to expand the capacity of the traditional dental team. Currently, dental therapists are permitted in Washington state on Tribal lands. This is thanks to the 2017 Dental Therapy Bill for Tribal lands, which I am proud to have supported. The University of Washington’s study published in 2017 on Alaska’s implementation of dental therapists found that “higher availability of dental therapists was significantly linked to a lower incidence of children having dental care under general anesthesia, which is usually related to extensive dental work.” In areas where this resource has already been implemented, including 12 U.S. states, this is true.

While the cost of living continually increases, everyday expenses for the basics take precedence over non-emergency dental care for many families with low incomes. We must guarantee all children and families have access to affordable dental care. Starting routine dental checkups as children is a proven way to help save families from future dental costs. We now know that poor dental hygiene can also lead to diseases like heart disease, diabetes and osteoporosis.

Several years ago, I accompanied a child welfare caseworker to an elementary school on a child abuse investigation. We interviewed a young child who, when he walked into the interview room, looked like he was in pain. As he talked, it was clear that his incisor was totally decayed. It was gray. I can’t imagine the pain that child was experiencing, and the inability of his parents to provide him with the dental care he needed. It was so preventable.

Our data shows how jarring the inequities within the state are. A recent survey found children of color suffer from higher rates of tooth decay than white children. Less than half of children from low-income families have access to any dental care, even those on Medicaid because so few dentists accept it.

If the past two years have taught us anything, it is that having access to good health care is critical for everyone. Last year the Legislature funded a task force to assess dental therapy, and its findings remove any doubt that dental therapy is a safe and effective solution to increase access.

We know how to fix this problem, so why aren’t we doing it? The Dental Association’s well-funded campaign is working against us, and their funding has demonstrated its power year after year. The task force report gives the Legislature a strong rebuttal against the Dental Association’s opposition and provides the needed evidence to support passage of this bill.

The solution is clear, we need to finally approve the expansion of dental therapy, beyond our tribal lands, for the well-being of everyone.

Ruth Kagi is a former Washington State legislator, who served the 32nd district. She dedicated the majority of her 20-year tenure to bettering the lives of the women and children of Washington state. She retired from her position in 2019.