Current Events

The Dental Cartel

The New York Times reports (“Dental Clinics…“) that the American Dental Association’s branch in Alaska has filed a lawsuit to stop dental therapists from practicing. 

The dental associations say they simply want to be sure that patients do not receive substandard care. But some dentists in public health programs contend that dentists in private practice consider therapists low-cost competition. In Alaska, the federally financed program that supplies care to Alaska Natives pays therapists about $60,000 a year, one-half to one-third of what dentists typically earn.”

Who are dental therapists?  Generally, one can think of them as similar to physician assistants or nurse practitioners in the dental world.  To qualify as a dental therapist, candidates must undergo a two year training program.  In Alaska, dental therapists may practice basic surgical procedures such as drilling and filling cavities and performing routine tooth extractions.  Dental therapists may be cheaper, but are they doing a good job?

So far, the program appears to be providing high-quality care, according to one study in 2006. The study, by the Baylor College of Dentistry, looked at about 600 procedures in more than 400 patients and found that the quality of procedures performed by therapists was no different from that provided by dentists.


  1. Note that the only way that the dentists can maintain their monopoly is through state action: laws. In a free market, it would be next to impossible for dentists (or interior designers, or otherwise) from maintaining the “licensure” monopoly.

  2. Sounds to me like this is similar to the AMA’s push to take away nurse practitioner’s ability to prescribe medications in some states, particularly in that it seems intended to preserve the artificial scarcity of services to keep costs high, rather than having anything to do with care outcomes.

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