The Future Direction of Dental Therapy Education Programs

This report, the Future Direction of Dental Therapy Education Programs , supported by the ADEAGies Foundation and conducted under the auspices of the National Coalition of Dentists for Health Equity, addresses an important and developing component of education and training of oral health workers in the United States.Fifteen states, almost one-third of the states, have passed legislation permitting dental therapists to practice.Legislative initiatives are underway in other states.However, during the time of this study (2025)(2026), there were only four dental therapy education programs functioning in three states.This report presents papers that first include background on dental therapy providers as a way to improve access to oral health care, followed by six papers that describe the development history of dental therapy education programs.One of those reports is a paper describing an innovative scholarship program supporting out-of-state education for dental therapy students who are then required to return to the sponsoring state to practice.Collectively, these papers tell a compelling story of success regarding dental therapy education programs providing a pathway for dental therapists to enter the oral health workforce.It should be noted that the passage of dental therapy legislation in fifteen states, which set the stage for these education programs, was not accomplished simply.The successful legislative efforts faced extensive opposition.However, documentation of the unaddressed issues of access to care and oral health inequities affecting populations in those states proved to be a compelling influence in passage of dental therapy legislation.The existing oral health service delivery system unfortunately seems incapable of assuring access to care for all and ameliorating the oral health inequities that affect select population groups.The current oral health delivery system can be described by the common expression, "the population comparatively least in need of care, receives the most care; the population comparatively most in need of care, receives the least care."It's the latter population that experiences the heavy load of oral health inequities.The fundamental roots of oral health inequities are deep and historical.When the Medicaid and Medicare programs were initiated in 1965, dentists fought against inclusion of any form of dental care coverage in those programs.The effort to keep dental coverage out of Medicaid was not successful, but today, only about 20% of general practice dentists nationally participate in their state's Medicaid program.The effort to withhold dental coverage in the Medicare program was successful, and routine dental care is not included among its benefits.Currently, the Medicare program supports the entire hospital system in the United States.The portion of the population 65 years of age and older is large and growing.Imagine the beneficial effect that even a minimal oral health benefit in Medicare might have on the oral health care delivery system today.The establishment of dental therapy practice opens a pathway for access to oral health care services that the existing structure either cannot or is resistant to providing to underserved communities.The state legislation regarding dental therapy practice stipulates that services must be focused on underserved communities and populations that otherwise receive the least care.This report should stimulate consideration of education programs to educate dental therapists in states with legislation supporting dental therapy practice, but without an education program.This report should also help fuel the interest in states with no supporting legislation for the practice of dental therapy to correct that deficit as a means to increase access to care for underserved populations.We trust that readers of this report will be informed, encouraged, and motivated regarding the future of dental therapy education and the contribution that dental therapist providers, in collaborative practice or in partnership with dentists, will make to increase access to care and address oral health inequities.Please note that during the latter stages of compiling this report, two additional dental therapy education programs in two additional states, Wisconsin and Oregon, were accredited by the Commission on Dental Accreditation.Those programs will soon be matriculating students.See the table in Appendix 1 for the contact information of the contributing authors for this report and for the new education programs.