FOOTNOTES

  1. Donald L. Chi, Dane Lenaker, Lloyd Mancl, Matthew Dunbar, and Michael Babb, “Dental Utilization for Communities Served by Dental Therapists in Alaska’s Yukon Kuskokwim Delta: Findings from an Observational Quantitative Study” (Aug. 11, 2017), http://faculty.washington.edu/dchi/files/DHATFinalReport.pdf; David A. Nash et al., “A Review of the Global Literature on Dental Therapists,” (2012) http://www.wkkf.org/-/media/pdfs/dental-therapy/nash-dental-therapist-literature-review.ASHX; The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf.
  2. The Pew Charitable Trusts, “Expanding the Dental Team,” (Feb 2014), http://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2014/expandingdentalteamreportpdf.pdf; The Pew Charitable Trusts, “Expanding the Dental Team: Increasing Access to Care in Public Settings,” (June 2014), http://www.pewtrusts.org/~/media/Assets/2014/06/27/Expanding_Dental_Case_Studies_Report.pdf; Wilder Research and Delta Dental of Minnesota, “Grand Marais Family Dentistry: Dental Therapist Case Study,” (May 2017) http://www.wilder.org/Wilder-Research/Publications/Studies/Delta%20Dental%20of%20Minnesota/Grand%20Marais%20Family%20Dentistry%20-%20Dental%20Therapist%20Case%20Study.pdf) Wilder Research and Delta Dental of Minnesota, “Midwest Dental: Dental Therapist Case Study,” (May 2017) https://www.wilder.org/Wilder-Research/Publications/Studies/Delta%20Dental%20of%20Minnesota/Midwest%20Dental%20-%20Dental%20Therapist%20Case%20Study.pdf.
  3. Minnesota Department of Health, “Minnesota’s Dental Therapist Workforce, 2016,” (2017) http://www.health.state.mn.us/divs/orhpc/workforce/oral/2016dtb.pdf.
  4. The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf.
  5. The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf.
  6. The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf.
  7. The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf.
  8. The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf. The total number of new patients served by dental therapists at study clinics since the time the dental therapists were hired (first hired in August 2011) through the end of the survey period (July 2013) was 6,338. Each patient is counted once. The average hours worked by the dental therapist over the survey period ranged from 1 hour/week to 36 hours/week at multiple study sites, which equals approximately seven full-time equivalents (FTEs).
  9. Donald L. Chi, Dane Lenaker, Lloyd Mancl, Matthew Dunbar, and Michael Babb, “Dental Utilization for Communities Served by Dental Therapists in Alaska’s Yukon Kuskokwim Delta: Findings from an Observational Quantitative Study” (Aug. 11, 2017), http://faculty.washington.edu/dchi/files/DHATFinalReport.pdf.
  10. Donald L. Chi, Dane Lenaker, Lloyd Mancl, Matthew Dunbar, and Michael Babb, “Dental Utilization for Communities Served by Dental Therapists in Alaska’s Yukon Kuskokwim Delta: Findings from an Observational Quantitative Study” (Aug. 11, 2017), http://faculty.washington.edu/dchi/files/DHATFinalReport.pdf.
  11. The Pew Charitable Trusts, “Expanding the Dental Team,” (June 2014), http://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2014/expandingdentalteamreportpdf.pdf; Kamyar Nasseh, Marko Vujicic, and Cassandra Yarbrough, “A Ten-Year, State-by-State, Analysis of Medicaid Fee-for-Service Reimbursement Rates for Dental Care Services,” The American Dental Association (October 2014), http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1014_3.ashx. In 2013, Minnesota had the lowest Medicaid FFS reimbursement for pediatric dental care services in the country.
  12. Wilder Research and Delta Dental of Minnesota, “Grand Marais Family Dentistry: Dental Therapist Case Study,” (May 2017) (http://www.wilder.org/Wilder-Research/Publications/Studies/Delta%20Dental%20of%20Minnesota/Grand%20Marais%20Family%20Dentistry%20-%20Dental%20Therapist%20Case%20Study.pdf); Wilder Research and Delta Dental of Minnesota, “Midwest Dental: Dental Therapist Case Study,” (May 2017) (https://www.wilder.org/Wilder-Research/Publications/Studies/Delta%20Dental%20of%20Minnesota/Midwest%20Dental%20-%20Dental%20Therapist%20Case%20Study.pdf).
  13. Wilder Research and Delta Dental of Minnesota, “Grand Marais Family Dentistry: Dental Therapist Case Study,” (May 2017) (http://www.wilder.org/Wilder-Research/Publications/Studies/Delta%20Dental%20of%20Minnesota/Grand%20Marais%20Family%20Dentistry%20-%20Dental%20Therapist%20Case%20Study.pdf); Wilder Research and Delta Dental of Minnesota, “Midwest Dental: Dental Therapist Case Study,” (May 2017) (https://www.wilder.org/Wilder-Research/Publications/Studies/Delta%20Dental%20of%20Minnesota/Midwest%20Dental%20-%20Dental%20Therapist%20Case%20Study.pdf
  14. The Pew Charitable Trusts, “Expanding the Dental Team: Increasing Access to Care in Public Settings,” (June 2014), http://www.pewtrusts.org/~/media/Assets/2014/06/27/Expanding_Dental_Case_Studies_Report.pdf.
  15. Apple Tree Dental, “An Advanced Dental Therapist in Long-Term Care: An Apple Tree Dental Case Study,” (2017), http://www.appletreedental.org/wp-content/uploads/2017/09/ADT-LTC-Case-Study-091517.pdf.
  16. Apple Tree Dental, “An Advanced Dental Therapist in Long-Term Care: An Apple Tree Dental Case Study,” (2017), http://www.appletreedental.org/wp-content/uploads/2017/09/ADT-LTC-Case-Study-091517.pdf. Due to the difference in salaries of a DDS and an ADT, the ADT provided 234 days of care at an estimated annual cost savings of $52,000 ($222/day).
  17. Scott Wetterhall, James D. Bader, Barri B. Burrus, Jessica Y. Lee, and Daniel A. Shugars, “Evaluation of the Dental Health Aide Therapist Workforce Model in Alaska,” RTI International (RTI Project Number 0211727.000.001) (October 2010), http://www.rti.org/sites/default/files/resources/alaskadhatprogramevaluationfinal102510.pdf; David A. Nash, Jay W. Friedman, Kavita R. Mathu-Muju, Peter G. Robinson, Julie Satur, Susan Moffat, Rosemary Kardos, Edward C.M. Lo, Anthony H.H. Wong, Nasruddin Jaafar, Jos van den Heuvel, Prathip Phantumvanit, Eu Oy Chu, Rahul Naidu, Lesley Naidoo, Irving McKenzie and Eshani Fernando, “A Review of the Global Literature on Dental Therapists,” (2012) http://www.wkkf.org/-/media/pdfs/dental-therapy/nash-dental-therapist-literature-review.ASHX; The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf.
  18. David A. Nash, Jay W. Friedman, Kavita R. Mathu-Muju, Peter G. Robinson, Julie Satur, Susan Moffat, Rosemary Kardos, Edward C.M. Lo, Anthony H.H. Wong, Nasruddin Jaafar,
    Jos van den Heuvel, Prathip Phantumvanit, Eu Oy Chu, Rahul Naidu, Lesley Naidoo, Irving McKenzie and Eshani Fernando, “A Review of the Global Literature on Dental Therapists,” (2012) http://www.wkkf.org/-/media/pdfs/dental-therapy/nash-dental-therapist-literature-review.ASHX.
    David A. Nash, Jay W. Friedman, Kavita R. Mathu-Muju, Peter G. Robinson, Julie Satur, Susan Moffat, Rosemary Kardos, Edward C.M. Lo, Anthony H.H. Wong, Nasruddin Jaafar,
    Jos van den Heuvel, Prathip Phantumvanit, Eu Oy Chu, Rahul Naidu, Lesley Naidoo, Irving McKenzie and Eshani Fernando, “A Review of the Global Literature on Dental Therapists,” (2012) http://www.wkkf.org/-/media/pdfs/dental-therapy/nash-dental-therapist-literature-review.ASHX.
  19. J. Timothy Wright, “Do Midlevel Providers Improve the Population’s Oral Health?” The Journal of the American Dental Association 144, no 1 (Jan. 2013), http://jada.ada.org/article/S0002-8177(14)60574-2/pdf.
  20. Scott Wetterhall, James D. Bader, Barri B. Burrus, Jessica Y. Lee, and Daniel A. Shugars, “Evaluation of the Dental Health Aide Therapist Workforce Model in Alaska,” RTI International (RTI Project Number 0211727.000.001) (October 2010), http://www.rti.org/sites/default/files/resources/alaskadhatprogramevaluationfinal102510.pdf
  21. Scott Wetterhall, James D. Bader, Barri B. Burrus, Jessica Y. Lee, and Daniel A. Shugars, “Evaluation of the Dental Health Aide Therapist Workforce Model in Alaska,” RTI International (RTI Project Number 0211727.000.001) (October 2010), http://www.rti.org/sites/default/files/resources/alaskadhatprogramevaluationfinal102510.pdf
  22. Commission on Dental Accreditation (CODA), “Accreditation Standards for Dental Therapy Education Programs,” (2015) http://www.ada.org/en/~/media/CODA/Files/dt.
  23. Health Resources & Services Administration, Data Warehouse, data on dental professional health shortage areas in Arizona as of August 23, 2017.
  24. American Dental Association (ADA) Health Policy Institute (HPI), (2015), “Oral Health and Well-Being in Arizona,” http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/OralHealthWell-Being-StateFacts/Arizona-Oral-Health-Well-Being.pdf.
  25. The Pew Charitable Trusts, analysis using data from the Arizona State Board of Dental Examiners, 2016; United States Census Bureau, “QuickFacts: Apache County, Arizona,” as of September 25, 2017, https://www.census.gov/quickfacts/AZ.
  26. American Association of Nurse Practitioners, “NP Fact Sheet” (June 6, 2107) https://www.aanp.org/images/documents/about-nps/npfacts.pdf; American Academy of PAs, “America Needs PAs,” (2017) https://www.aapa.org/wp-content/uploads/2017/02/50th%E2%80%93America-Needs-PAs-Brochure-ENGLISH_DIGITAL-1.pdf.
  27. Commission on Dental Accreditation (CODA), “Accreditation Standards for Dental Therapy Education Programs,” (2015) http://www.ada.org/en/~/media/CODA/Files/dt.
  28. The American Dental Association, “Breaking Down Barriers to Oral Health for All Americans: Repairing the Tattered Safety Net, August 2011, http://www.ada.org/~/media/ADA/Public%20Programs/Files/barriers-paper_repairing-tattered-safety-net.pdf?la=en; The Pew Charitable Trusts, “Who Can’t Get Dental Care?” (May, 31, 2017) http://www.pewtrusts.org/en/research-and-analysis/analysis/2017/05/31/who-cant-get-dental-care.
  29. The American Dental Association, “Breaking Down Barriers to Oral Health for All Americans: Repairing the Tattered Safety Net, August 2011, http://www.ada.org/~/media/ADA/Public%20Programs/Files/barriers-paper_repairing-tattered-safety-net.pdf?la=en; The Pew Charitable Trusts, “Who Can’t Get Dental Care?” (May, 31, 2017) http://www.pewtrusts.org/en/research-and-analysis/analysis/2017/05/31/who-cant-get-dental-care; Mary Jordan and Kevin Sullivan, “The Painful Truth about Teeth,” The Washington Post, May 13, 2017, http://www.washingtonpost.com/sf/national/2017/05/13/the-painful-truth-about-teeth/?utm_term=.6b723989aa4b.
  30. Health Resources and Services Administration, Health Professional Shortage Areas Statistics
  31. Mary Jordan and Kevin Sullivan, “The Painful Truth about Teeth,” The Washington Post, May 13, 2017, http://www.washingtonpost.com/sf/national/2017/05/13/the-painful-truth-about-teeth/?utm_term=.6b723989aa4b; Colin Campbell, The Baltimore Sun, “University of Maryland, Catholic Charities offer free dental service in College Park,” Sept. 19, 2017, http://www.baltimoresun.com/health/bs-md-dental-charity-20170910-story.html.
  32. American Dental Association (ADA) Health Policy Institute (HPI), (2015), “Oral Health and Well-Being in Arizona,” http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/OralHealthWell-Being-StateFacts/Arizona-Oral-Health-Well-Being.pdf.
  33. American Dental Association (ADA) Health Policy Institute (HPI), (2015), “Oral Health and Well-Being in Arizona,” http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/OralHealthWell-Being-StateFacts/Arizona-Oral-Health-Well-Being.pdf.
  34. American Dental Association (ADA) Health Policy Institute (HPI), (2015), “Oral Health and Well-Being in Arizona,” http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/OralHealthWell-Being-StateFacts/Arizona-Oral-Health-Well-Being.pdf.
  35. Pew Charitable Trusts, analysis using data from the Arizona State Board of Dental Examiners, 2016; United States Census Bureau, “QuickFacts: Apache County, Arizona,” as of September 25, 2017, https://www.census.gov/quickfacts/AZ.
  36. The Pew Charitable Trusts, analysis using data from the Arizona State Board of Dental Examiners, 2016; U.S. Census Bureau, “Scottsdale City: Land Area in Square Miles, 2010,” accessed Aug. 1, 2017, https://www.census.gov/quickfacts/fact/table/scottsdalecityarizona/PST045216.
  37. The Pew Charitable Trusts, analysis using data from the Arizona State Board of Dental Examiners, 2016; U.S. Census Bureau, Land Area in Square Miles for Coconino, Yavapai, Gila, and Navajo Counties,” accessed Aug. 1, 2017 (https://www.census.gov/quickfacts/fact/table/navajocountyarizona,gilacountyarizona,yavapaicountyarizona,coconinocountyarizona/PST045216).
  38. Kamyar Nasseh, et al. “A Ten-Year, State-by-State, Analysis of Medicaid Fee-for-Service Reimbursement Rates for Dental Care Services,” Health Policy Institute, American Dental Association (October 2014) http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1014_3.ashx
  39. Health Resources and Services Administration, Health Professional Shortage Areas Statistics
  40. Robert H. Selwitz, Amid I. Ismail, and Nigel B. Pitts, “Dental Caries,” The Lancet 369, no. 9555 (Jan 2007): 51-59, http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)60031-2.pdf.
  41. The Pew Charitable Trusts, “Dental Therapists in New Zealand: What the Evidence Shows,” (May 2013) http://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2013/pewnewzealanddentalbriefpdf.pdf.
  42. The Pew Charitable Trusts, “Dental Therapists in New Zealand: What the Evidence Shows,” (May 2013) http://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2013/pewnewzealanddentalbriefpdf.pdf
  43. The Pew Charitable Trusts, “Dental Therapists in New Zealand: What the Evidence Shows,” (May 2013) http://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2013/pewnewzealanddentalbriefpdf.pdf.
  44. Thomas Wall, Kamyar Nasseh,and Marko Vujicic, “Majority of Dental-Related Emergency Department Visits Lack Urgency and Can Be Diverted to Dental Offices,” The American Dental Association Health Policy Institute (August 2014) http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0814_1.ashx.
  45. J. Timothy Wright, Frank Graham, Catherine Hayes, Amid I. Ismail, Kirk W. Noraian,Robert J. Weyant, Sharon L. Tracy, Nicholas B. Hanson, and Julie Frantsve-Hawley, “A systematic review of oral health outcomes produced by dental teams incorporating midlevel providers,” Journal of the American Dental Association 144, no. 1: 75-91, https://ac.els-cdn.com/S0002817714605730/1-s2.0-S0002817714605730-main.pdf?_tid=c0751f26-a226-11e7-8365-00000aacb35e&acdnat=1506367478_facadf4ef58c1c47cd8d75ccc8dd94db.
  46.  The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf. The total number of new patients served by dental therapists at study clinics since the time the dental therapists were hired (first hired in August 2011) through the end of the survey period (July 2013) was 6,338. Each patient is counted once. The average hours worked by the dental therapist over the survey period ranged from 1 hour/week to 36 hours/week at multiple study sites, which equals approximately seven full-time equivalents (FTEs).
  47. The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf.
  48. “DHAT: Alaska and Beyond!” Presentation by Christina Peters and Pam Johnson, Native Dental Therapy Initiative, and John Stephens, Swinomish Indian Tribal Community, to the National Indian Health Board, June 8, 2017, https://www.nihb.org/docs/07182017_tphs/thursday/DHAT%27s%20Improving%20Both%20Oral%20Health%20Outcomes%20&%20Access-%20New%20Research%20from%20Alaska%20&%20New%20Policies.pdf.
  49. Donald L. Chi, Dane Lenaker, Lloyd Mancl, Matthew Dunbar, and Michael Babb, “Dental Utilization for Communities Served by Dental Therapists in Alaska’s Yukon Kuskokwim Delta: Findings from an Observational Quantitative Study” (Aug. 11, 2017), http://faculty.washington.edu/dchi/files/DHATFinalReport.pdf.
  50. Minnesota Department of Health, “Minnesota’s Dental Therapist Workforce, 2016,” (2017) http://www.health.state.mn.us/divs/orhpc/workforce/oral/2016dtb.pdf.
  51. Minnesota Department of Health, “Minnesota’s Dental Therapist Workforce, 2016,” (2017) http://www.health.state.mn.us/divs/orhpc/workforce/oral/2016dtb.pdf.
  52. Minnesota Department of Health, “Minnesota’s Dental Therapist Workforce, 2016,” (2017) http://www.health.state.mn.us/divs/orhpc/workforce/oral/2016dtb.pdf.
  53. The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf.
  54. David A. Nash, Jay W. Friedman, Kavita R. Mathu-Muju, Peter G. Robinson, Julie Satur, Susan Moffat, Rosemary Kardos, Edward C.M. Lo, Anthony H.H. Wong, Nasruddin Jaafar,
    Jos van den Heuvel, Prathip Phantumvanit, Eu Oy Chu, Rahul Naidu, Lesley Naidoo, Irving McKenzie and Eshani Fernando, “A Review of the Global Literature on Dental Therapists,” (2012) http://www.wkkf.org/-/media/pdfs/dental-therapy/nash-dental-therapist-literature-review.ASHX.
  55. Kavita R. Mathu-Muju, Jay W. Friedman, and David A. Nash, “Saskatchewan’s school-based dental program staffed by dental therapists: a retrospective case study,” Journal of Public Health Dentistry (2016): 1-8, doi: 10.1111/jphd.12184.
  56. The Pew Charitable Trusts, “Dentists and Dental Therapists in Private Practice: Two Case Studies,” (Feb. 2014) http://www.pewtrusts.org/~/media/assets/2014/02/12/dental_therapist_case_studies.pdf. In 2012, the average exchange rate for converting one Canadian dollar to one U.S. dollar was 1.040 (https://www.irs.gov/individuals/international-taxpayers/yearly-average-currency-exchange-rates).
  57. Donald L. Chi, Dane Lenaker, Lloyd Mancl, Matthew Dunbar, and Michael Babb, “Dental Utilization for Communities Served by Dental Therapists in Alaska’s Yukon Kuskokwim Delta: Findings from an Observational Quantitative Study” (Aug. 11, 2017), http://faculty.washington.edu/dchi/files/DHATFinalReport.pdf; David A. Nash et al., “A Review of the Global Literature on Dental Therapists,” (2012) http://www.wkkf.org/-/media/pdfs/dental-therapy/nash-dental-therapist-literature-review.ASHX; The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf.
  58. The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014); Donald L. Chi, Dane Lenaker, Lloyd Mancl, Matthew Dunbar, and Michael Babb, “Dental Utilization for Communities Served by Dental Therapists in Alaska’s Yukon Kuskokwim Delta: Findings from an Observational Quantitative Study” (Aug. 11, 2017).
  59. Apple Tree Dental, “An Advanced Dental Therapist in Long-Term Care: An Apple Tree Dental Case Study,” (2017), http://www.appletreedental.org/wp-content/uploads/2017/09/ADT-LTC-Case-Study-091517.pdf.
  60. Analysis by the Pew Charitable Trusts using the 2013 Code on Dental Procedures and Nomenclature (CDT).
  61. Inter-Tribal Council of Arizona, “Resolution 1016,” (Nov. 18, 2016), https://www.nihb.org/docs/03162017/ITCA%2011.18.16.pdf.
  62. 25 U.S.C. § 1616l(d), Community health aide program, Nationalization of program.
  63. Inter-Tribal Council of Arizona, “Resolution 1016,” (Nov. 18, 2016), https://www.nihb.org/docs/03162017/ITCA%2011.18.16.pdf.
  64. Resolution of the Naabik’iyati’ Committee of the Navajo Nation Council (2017) https://www.nihb.org/docs/03232017/Navajo%20Nation%20(Navajo)%20Resolution%20NABIMA-13-17.pdf
  65. Arizona Revised Statutes, Senate Bill 1457 (2016) https://apps.azleg.gov/BillStatus/GetDocumentPdf/442161; Arizona Revised Statutes, Senate Bill 1527 (2017) https://apps.azleg.gov/BillStatus/GetDocumentPdf/454119.
  66. AHCCCS, “Arizona’s Eligibility Policy Manual for Medical, Nutrition, and Cash Assistance: 403: Arizona Long Term Care System (ALTCS),” accessed April 4, 2017, https://www.healthearizonaplus.gov/PolicyManual/eligibilitypolicymanual/index.html#page/MA/MA400/MA0403.html.
  67. Health Resources & Services Administration, Data Warehouse, data on dental professional health shortage areas in Arizona as of August 23, 2017.
  68. The American Dental Association, “Breaking Down Barriers to Oral Health for All Americans: Repairing the Tattered Safety Net, August 2011, http://www.ada.org/~/media/ADA/Public%20Programs/Files/barriers-paper_repairing-tattered-safety-net.pdf?la=en; The Pew Charitable Trusts, “Who Can’t Get Dental Care?” (May, 31, 2017) http://www.pewtrusts.org/en/research-and-analysis/analysis/2017/05/31/who-cant-get-dental-care.
  69. The American Dental Association, “Breaking Down Barriers to Oral Health for All Americans: Repairing the Tattered Safety Net, August 2011, http://www.ada.org/~/media/ADA/Public%20Programs/Files/barriers-paper_repairing-tattered-safety-net.pdf?la=en; The Pew Charitable Trusts, “Who Can’t Get Dental Care?” (May, 31, 2017) http://www.pewtrusts.org/en/research-and-analysis/analysis/2017/05/31/who-cant-get-dental-care; Mary Jordan and Kevin Sullivan, “The Painful Truth about Teeth,” The Washington Post, May 13, 2017, http://www.washingtonpost.com/sf/national/2017/05/13/the-painful-truth-about-teeth/?utm_term=.6b723989aa4b.
  70. American Dental Association (ADA) Health Policy Institute (HPI), (2015), “Oral Health and Well-Being in Arizona,” http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/OralHealthWell-Being-StateFacts/Arizona-Oral-Health-Well-Being.pdf.
  71. Regina M. Benjamin, “Oral Health: The Silent Epidemic,” Public Health Reports 125, no. 2 (2010): 158–159, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821841/pdf/phr125000158.pdf.
  72. The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf.Arizona Early Childhood Development and Health Board (First Things First), “Taking a Bite Out of School Absences: Children’s Oral Health Report 2016,” 2016. Accessed on September 1, 2016 from http://azftf.gov/WhoWeAre/Board/Documents/FTF_Oral_Health_Report_2016.pdf.
  73. Arizona Early Childhood Development and Health Board (First Things First), “Taking a Bite Out of School Absences: Children’s Oral Health Report 2016,” 2016. Accessed on September 1, 2016 from http://azftf.gov/WhoWeAre/Board/Documents/FTF_Oral_Health_Report_2016.pdf.
  74. U.S. Census Bureau, Population Estimates Program (PEP), as of July 1, 2016, https://www.census.gov/quickfacts/fact/table/AZ/PST045216.
  75. “DHAT: Alaska and Beyond!” Presentation by Christina Peters and Pam Johnson, Native Dental Therapy Initiative, and John Stephens, Swinomish Indian Tribal Community, to the National Indian Health Board, June 8, 2017, https://www.nihb.org/docs/07182017_tphs/thursday/DHAT%27s%20Improving%20Both%20Oral%20Health%20Outcomes%20&%20Access-%20New%20Research%20from%20Alaska%20&%20New%20Policies.pdf.
  76. Minnesota Department of Health, “Minnesota’s Dental Therapist Workforce, 2016,” (2017) http://www.health.state.mn.us/divs/orhpc/workforce/oral/2016dtb.pdf.
  77. The Minnesota Department of Health and the Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” (2014), http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf. The total number of new patients served by dental therapists at study clinics since the time the dental therapists were hired (first hired in August 2011) through the end of the survey period (July 2013) was 6,338. Each patient is counted once. The average hours worked by the dental therapist over the survey period ranged from 1 hour/week to 36 hours/week at multiple study sites, which equals approximately seven full-time equivalents (FTEs).
  78. State statistics from HCUP State Inpatient Databases and State Emergency Department Databases 2014, Agency for Healthcare Research and Quality (AHRQ), based on data collected by the Arizona Department of Health Services, using ICD-9 codes: 521.00, 521.01, 521.02, 521.03, 521.04, 521.05, 521.06, 521.07, 521.08, 521.09, 522.0, 522.1, 522.2, 522.3, 522.4, 522.5, 522.6, 522.7, 522.8, 522.9, 523.00, 523.01, 523.10, 523.11, 523.20, 523.21, 523.22, 523.23, 523.24, 523.25, 523.3-523.33, 523.30, 523.31, 523.32, 523.33, 523.40, 523.41, 523.42, 523.5, 523.6, 523.8, 523.9, 528.3.
  79. Veerasathpurush Allareddy, Sankeerth Rampa, Min Kyeong Lee, Veerajalandhar Allareddy, and Romesh P. Nalliah, ”Hospital-based emergency department visits involving dental conditions,” The Journal of the American Dental Association 145, no. 4 (2014): 331-337, doi:10.14219/jada.2014.7. This figure was calculated based on the estimated average cost of an ED dental visit, $760 per visit (adjusted for 2010 dollars) using ICD-9 codes 521.00, 521.01, 521.02, 521.03, 521.04, 521.05, 521.06, 521.07, 521.08, 521.09, 522.0, 522.1, 522.2, 522.3, 522.4, 522.5, 522.6, 522.7, 522.8, 522.9, 523.00, 523.01, 523.10, 523.11, 523.20, 523.21, 523.22, 523.23, 523.24, 523.25, 523.3, 523.30, 523.31, 523.32, 523.33, 523.40, 523.41, 523.42, 523.5, 523.6, 523.8, 523.9, and 528.3, and the Arizona state statistics from HCUP (using the same ICD-9 codes): 760*26,880=20,428,800.
  80. State statistics from HCUP State Inpatient Databases and State Emergency Department Databases 2014, Agency for Healthcare Research and Quality (AHRQ), based on data collected by the Arizona Department of Health Services, using ICD-9 codes: 521.00, 521.01, 521.02, 521.03, 521.04, 521.05, 521.06, 521.07, 521.08, 521.09, 522.0, 522.1, 522.2, 522.3, 522.4, 522.5, 522.6, 522.7, 522.8, 522.9, 523.00, 523.01, 523.10, 523.11, 523.20, 523.21, 523.22, 523.23, 523.24, 523.25, 523.3-523.33, 523.30, 523.31, 523.32, 523.33, 523.40, 523.41, 523.42, 523.5, 523.6, 523.8, 523.9, 528.3
  81. David A. Nash et al., “A Review of the Global Literature on Dental Therapists,” (2012) http://www.wkkf.org/-/media/pdfs/dental-therapy/nash-dental-therapist-literature-review.ASHX/
  82. Analysis by the Pew Charitable Trusts using the 2013 Code on Dental Procedures and Nomenclature (CDT).
  83. University of Minnesota School of Dentistry, Normandale Community College, and Metropolitan State University, “Hiring a Dental Therapist or Advanced Dental Therapist: Professional Liability,” accessed September 19 2017, https://www.mchoralhealth.org/mn/dental-therapy/professional-liability.html.
  84. University of Minnesota School of Dentistry, Normandale Community College, and Metropolitan State University, “Hiring a Dental Therapist or Advanced Dental Therapist: Professional Liability,” accessed September 19 2017, https://www.mchoralhealth.org/mn/dental-therapy/professional-liability.html.
  85. Arizona Health Care Cost Containment System (AHCCCS), “2017 Access Monitoring Analysis,” (May 2017)
  86. This figure counts children ages 1 to 20 who were eligible for the Early and Periodic Screening, Diagnostic and Treatment Benefit for 90 continuous days and received any dental service. See U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, Annual EPSDT Participation Report, Form CMS-416 (State) Fiscal Year: 2016, as of September 7, 2017, https://www.medicaid.gov/medicaid/benefits/epsdt/index.html.
  87. Kathy Phipps, “Taking a Bite Out of School Absences: Children’s Oral Health Report 2016,” Arizona Early Childhood Development and Health Board (First Things First) (2016), http://azftf.gov/WhoWeAre/Board/Documents/FTF_Oral_Health_Report_2016.pdf.
  88. Cassandra Yarbrough, Kamyar Nasseh, and Marko Vujicic, “Why Adults Forgo Dental Care: Evidence from a New National Survey,” The American Dental Association Health Policy Institute, (2014), http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1114_1.ashx.
  89. Arizona Revised Statutes, Senate Bill 1527 (2017) https://apps.azleg.gov/BillStatus/GetDocumentPdf/454119.
  90. Arizona state statistics from HCUP State Inpatient Databases and State Emergency Department Databases 2014, Agency for Healthcare Research and Quality (AHRQ), based on data collected by the Arizona Department of Health Services, using ICD-9 codes 521.00, 521.01, 521.02, 521.03, 521.04, 521.05, 521.06, 521.07, 521.08, 521.09, 522.0, 522.1, 522.2, 522.3, 522.4, 522.5, 522.6, 522.7, 522.8, 522.9, 523.00, 523.01, 523.10, 523.11, 523.20, 523.21, 523.22, 523.23, 523.24, 523.25, 523.3-523.33, 523.30, 523.31, 523.32, 523.33, 523.40, 523.41, 523.42, 523.5, 523.6, 523.8, 523.9, and 528.3.
  91. Veerasathpurush Allareddy, Sankeerth Rampa, Min Kyeong Lee, Veerajalandhar Allareddy, and Romesh P. Nalliah, ”Hospital-based emergency department visits involving dental conditions,” The Journal of the American Dental Association 145, no. 4 (2014): 331-337, doi:10.14219/jada.2014.7. This figure was calculated based on the estimated average cost of an ED dental visit, $760 per visit (adjusted for 2010 dollars) using ICD-9 codes 521.00, 521.01, 521.02, 521.03, 521.04, 521.05, 521.06, 521.07, 521.08, 521.09, 522.0, 522.1, 522.2, 522.3, 522.4, 522.5, 522.6, 522.7, 522.8, 522.9, 523.00, 523.01, 523.10, 523.11, 523.20, 523.21, 523.22, 523.23, 523.24, 523.25, 523.3, 523.30, 523.31, 523.32, 523.33, 523.40, 523.41, 523.42, 523.5, 523.6, 523.8, 523.9, and 528.3, and the Arizona state statistics from HCUP (using the same ICD-9 codes): 760*26,880=20,428,800.
  92. Arizona state statistics from HCUP State Inpatient Databases and State Emergency Department Databases 2014, Agency for Healthcare Research and Quality (AHRQ), based on data collected by the Arizona Department of Health Services, using ICD-9 codes 521.00, 521.01, 521.02, 521.03, 521.04, 521.05, 521.06, 521.07, 521.08, 521.09, 522.0, 522.1, 522.2, 522.3, 522.4, 522.5, 522.6, 522.7, 522.8, 522.9, 523.00, 523.01, 523.10, 523.11, 523.20, 523.21, 523.22, 523.23, 523.24, 523.25, 523.3-523.33, 523.30, 523.31, 523.32, 523.33, 523.40, 523.41, 523.42, 523.5, 523.6, 523.8, 523.9, and 528.3.
  93. Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health, “Oral Health Data: Arizona,” accessed September 25, 2017, https://www.cdc.gov/oralhealthdata/.
  94. Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health, “Oral Health Data: Arizona,” accessed September 25, 2017, https://www.cdc.gov/oralhealthdata/.
  95. Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health, “Oral Health Data: Arizona,” accessed September 25, 2017, https://www.cdc.gov/oralhealthdata/.
  96. U. S. Census Bureau, “QuickFacts: Arizona, persons 65 years and over, percent July 1, 2016,” accessed September 25, 2017.
  97. HHS Centers for Medicare and Medicaid Services, “Nursing Home Data Compendium 2015 Edition,” 2015, https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/nursinghomedatacompendium_508-2015.pdf
  98. HHS ACL AGID, “Profile of State OAA Programs: Arizona,” data as of 2014, https://agid.acl.gov/StateProfiles/Profile/Pre/?id=3&topic=0&years=2014.
  99. Arizona Health Care Cost Containment System (AHCCCS), “AHCCCS Population Demographics, Feb. 13, 2017, https://www.azahcccs.gov/Resources/Downloads/PopulationStatistics/2017/Feb/AHCCCS_Demographics.pdf
  100. AHCCCS, “AHCCCS Medical Policy Manual, 310-D1: Dental Services for Members 21 Years of Age and Older,” revised 10/01/16, https://www.azahcccs.gov/shared/Downloads/MedicalPolicyManual/310D1.pdf.
  101. AHCCCS, “AHCCCS Medical Policy Manual, 310-D2: Arizona Long Term Care System Adult Dental Services,” effective 10/01/16, https://www.azahcccs.gov/shared/Downloads/MedicalPolicyManual/310D2.pdf.
  102. AHCCCS, “Arizona’s Eligibility Policy Manual for Medical, Nutrition, and Cash Assistance: 403: Arizona Long Term Care System (ALTCS),” accessed April 4, 2017, https://www.healthearizonaplus.gov/PolicyManual/eligibilitypolicymanual/index.html#page/MA/MA400/MA0403.html.