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Dental industry skeptical of proposed legislative changes

Special to the Legal News

Published: July 13, 2017

Dental professionals are pessimistic a bill devised to expand quality dental care to more Ohioans, including those covered by Medicaid, would reach the lofty goals envisioned by the bill's joint sponsors.

During the most recent hearing before Health Committee members in the Ohio House of Representatives, lawmakers heard testimony from interested parties, including dentists and the state association representing dental hygenists.

The bill's shortcomings, opponents say, would largely overshadow the benefits of the House Bill 184, which would authorize the provision of dental services through teledentistry and make other changes to the laws governing the practices of dentistry and dental hygiene.

The bill's teledentistry provision is a positive step, according to Ohio Dental Hygienists' Association Past President Nichole Oocumma, but it raises important issues, including questions about supervision.

"A dentist using a teledentistry permit can supervise three Registered Dental Hygienists and Expanded Function Dental Auxiliaries at any time," she told committee members. "Since the stated goal is to create an extension of a dentist working from a hospital clinic setting or a private dental office in Columbus because there are too few dentists in Appalachia, we question how a dentist can supervise up to four RDHs in their office, potentially three RDHs working under an Oral Health Access Supervision Permit and now three RDHs and three EFDAs in a teledentistry scenario."

Current law prohibits a dentist from supervising more than two EFDAs in a given practice.

"Are we trying to expect too much of the dentist involved in these different supervision types?" Oocumma asked. "If a dentist used all the authority granted by the state, they could be supervising 15 people at the same time, six of which are in synchronous, real time.

"Are we compromising patient care and not protecting the citizens of Ohio?"

Dr. Edward Sterling, past director of Ohio State University's Nisonger Center Dental Program, believes the bill would only forestall dental health issues for the poorest Ohioans.

"There is no commitment or requirement that the supervising dentist will provide the care needed that exceeds the scope of HB 184," he explained.

Another provision of the bill would double the capacity of the state's Dentist Student Loan Repayment Program.

"Over the last decade, the Ohio Dentist Loan Repayment Program has incentivized dozens of dentists through loan repayment assistance to relocate to designated underserved areas and provide care to thousands of Medicaid patients and other low income Ohioans," said Rep. Theresa Charters Gavarone, R-Bowling Green, one of the joint sponsors of the bill. "This program is entirely funded by a surcharge on Ohio dentists' licensure fees.

"Participants do not receive any taxpayer funds. House Bill 184 will double this surcharge, greatly augmenting the capacity of the program to incentivize more dentists to relocate to underserved areas and provide care to those most in need."

Former Cincinnati Health Department Dental Director Dr. Larry Hill said HB 184 missed the mark and characterized it as a diversionary tactic of the Ohio Dental Association and the College of Dentistry at the Ohio State University.

"We have a real access to dental care problem in Ohio," Hill began. "However, the problem is not unique to Ohio.

"Medicare has no coverage for dental care and (it) doesn't work very well under Medicaid. ... Specifically in Ohio, too many children are not receiving dental sealants and too many seniors cannot afford even routine dental care."

Rep. Anthony DeVitis, R-Uniontown, Gavarone's fellow joint sponsor, was confident that the state's larger-than-average dentist population would be able to solve the access issue with the help of HB 184.

At time of publication, the bill had not been scheduled for further hearing.

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