ASDA Midlevel Provider Talking Points
ASDA’s stance on midlevel providers
ASDA identifies a midlevel provider as an individual, who is not a dentist with four years of post-collegiate education
(three years in the case of University of the Pacific School of Dentistry), who may perform irreversible procedures on the
public. The association believes the dentist is the only dental provider that should perform the following functions:
- Diagnosis and treatment planning
- Prescribing work authorizations
- Performing surgical/irreversible dental procedures
- Prescribing drugs and/or other medications
History of midlevel providers in the United States
- Barriers to care limit or prevent people from receiving adequate health care. The most common are:
o financial hardship
o geographic location
o pressing health needs
o poor oral health literacy
- There are 5,833 Dental Health Professional Shortage Areas (HPSAs).
- More than 10,635 practitioners are needed to meet every HPSAs’ need.
- Midlevel Providers were created in response to barriers to care and the HPSA crisis. A key attribute of a midlevel
provider is that he/she was intended to primarily work in settings that serve populations with minimal access to
dental care (1).
- Dental therapists were first authorized to practice in Minnesota in 2009, with the Minnesota Board of Dentistry
licensing its first dental therapist in 2011 (1).
Midlevel provider models:
- International perspective: Proponents of midlevel providers oftentimes reference midlevel models from Canada
and New Zealand. Here are some key facts of those programs:
o Canada:
The Canadian dental therapy program ended in 2011 (2).
These providers were established for nearly 40 years, but it was deemed to be an unsustainable
option for increasing access to care.
70% of dental therapists were not practicing within the areas of need.
o New Zealand:
Has an established program.
In a publication, it presented that only 3% of children aged 5 to 11 had untreated tooth decay
(3). However, when examined, New Zealand data only included permanent dentition (adult
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