At a Mackinac Center event on how states can improve healthcare coverage and reduce costs, a panelist mentioned using dental therapists to expand access to dental care and make it more affordable. These midlevel providers practice under the supervision of a dentist but provide more services than a dental hygienist. Michigan law lets them practice, but the required regulatory changes are being implemented at the speed of bureaucracy.
Lawmakers created a dental therapist license in 2018. The rationale was to expand dental care in underserved regions, such as rural areas. Dental therapists specialize in providing the most common services that typical patients need, and they can operate clinics at a lower cost than a full-fledged dental practice. This enables them to provide services in places with lower population density.
But in the eight years since the law was enacted, the state has licensed just two dental therapists: one in 2025 and one last month. Despite this dismal record, the state health department claims that expanding access to care via dental therapists is “an important focus for the department.”
Compare this to Minnesota’s experience. Lawmakers there created a dental therapist license in 2009, the nation’s first. Within five years the state endorsed 32 therapists who served about 6,300 patients over a 16-month period.
Michigan lawmakers expected something similar here. They required the state health department to publish a report seven years after the law took effect to assess its impact. It required measurements of how many new patients dental therapists served and the outcomes of the new license, such as reductions in patient wait times, distance traveled to receive care and emergency room use.
The department published the study in April. With just two dental therapists licensed, there was nothing to report to the Legislature. The department blamed the COVID-19 pandemic for delaying “workforce development activities and the establishment of in-state education and training pathways.”
To be fair, the state faces a significant challenge in licensing new dental therapists: There are no dental therapist training programs in Michigan and only five in the whole country. That makes it difficult for the state to grow and train its own dental therapists.
In Minnesota, on the other hand, the University of Minnesota and Metro State University both enrolled students in dental therapy training programs just months after lawmakers created the license. To its credit, Michigan’s health department is partnering with Ferris State University to establish a training program. It is “anticipated to launch,” the department says, in 2028.
Minnesota showed that dental therapy can move from statute to real-world patient care in just a few years. Michigan, by contrast, has spent nearly a decade inching forward. If state officials are serious about improving access and affordability, they should follow the evidence — and pick up the pace.
