Open Wide - The Official Blog of The Chicago Dental Society

Permanent link  Help keep adult dental services in the Medicaid program


Did you receive an email from the Bridge to Healthy Smiles campaign today?  It reminded local voters that Illinois Governor Pat Quinn and the State Legislature are conducting a review of all Medicaid services to find $2.7 billion in budget cuts. Adult dental services are on the chopping block for possible elimination due to their classification as “optional services” under federal reimbursement guidelines.

The Bridge to Healthy Smiles campaign urged voters to help the governor and their elected officials understand that elimination of the adult services is not the answer; it will instead shift the burden to emergency rooms that can not treat the underlying dental condition.

You can read the full message from the Bridge to Health Smiles campaign here.

If you agree and want to help, the Bridge to Healthy Smiles campaign encourages you to call Gov. Quinn and your legislators and explain why they must not cut the adult dental funding and what the impact will be on the underserved population. 

Governor Quinn’s office can be reached at 217.782.0244 during business hours.

The Illinois State Dental Society has provided on its website links to help you identify your elected representative, and an outline of talking points for when you call that person’s legislative office:

  • The adult dental program is a state-optional program and only accounts for about 20 percent ($51 million) of the entire dental appropriation in the FY-12 budget, which is projected to be $300 million. Since the federal government pays half of the Medicaid costs, the State of Illinois’ savings would only be $25.5 million.
  • If the adult dental program is eliminated, much or all of the savings in the dental appropriation would be offset due to increased State spending for those patients who present to hospital emergency rooms seeking pain relief.
  • In most cases, emergency rooms are only able to provide pain medication and antibiotics, which temporarily address the clinical concerns.
  • The Pew Center issued a report on February 28, 2012, that documented a 15.8 percent increase in emergency room visits from 2006-2009 in states that reduced or eliminated adult dental care programs.





access to care , dental benefits , dental news , legislation , medicaid , public health , state of illinois ,

Permanent link  Cook County Board allocates $1 million for dental care


CDS member Cheryl Watson-Lowry joined Cook County Board President Toni Preckwinkle today to announce a $1 million earmark in the 2012 Cook County Health and Hospital System budget for outpatient dental care.

“These public health initiatives will be critical to treating our underserved residents at a time when families throughout Cook County are facing difficult economic circumstances,” President Preckwinkle said. “Because we made tough choices in our budget, we can invest in public health to ensure … our children can have access to the dental services they need and deserve.”

Cook County press conference on accessPresident Preckwinkle also announced today an additional $1 million allocation for the Access to Care organization, which facilitates primary care for residents of suburban Cook Country at reduced rates. Private physicians care for qualified patients in their private offices. This brings the County’s total funding for the Access to Care organization to $3 million this year.

Ramanathan Raju, MD, CEO of the Cook Country Hospital System, called it “a great day for the health of Cook County residents.”

“In times of financial crisis, it takes courageous leadership and farsighted thinking to protect the health of our residents. As more people enroll (in public health systems), we need to think of innovative ways of partnering with the community and organizations to provide care,” Dr. Raju said.

Funding to restore dental care to the Cook County healthcare system has been a year-long battle for the Chicago Dental Society’s Government Affairs Committee. Members have met repeatedly with President Preckwinkle and various commissioners to explain that the federal government has designated large areas of Cook County as dental health professional shortage areas, and to educate commissioners about the importance of oral healthcare as part of whole body wellness.

Dr. Watson-Lowry, who chairs the Government Affairs Committee, was reinvigorated by today’s announcement.

“I am so excited that we are making progress, and that the underserved residents of Chicago and Cook County will receive the dental care that they deserve,” she said. “This will change lives. People who have not been able to find jobs because they are afraid to smile or to talk in public will be able to have their mouths restored so that they can eat and speak properly and seek employment.”

Also on hand for the announcement were commissioners John Daley (D-11th), also the Finance Committee chairman; Tim Schneider (R-15th); Peter Silvestri (R-9th); and Jeffrey Tobolski (D-16th).

“The world would be a better place if we smile at each other a little more. You can thank a dentist for that,” Mr. Silvestri said. 

“Sure enough,” President Preckwinkle replied. “I’m grateful for the bipartisan support for these additional funds for both Access to Care and the dental program.”

Pictured above (L-R): CDS executive director Randy Grove, Commissioner Jeffrey Tobolski (D-16th), CDS Government Affairs Committee chair Cheryl Watson-Lowry and Commissioner John Daley (D-11th).


access to care , dental care , dental news , legislation ,

Permanent link  Act now for Illinois HB 2239


Illinois dentists, ISDS is calling on you to contact Gov. Quinn about HB 2239, which repeals the 50% Illinois income tax increase for partnerships, LLCs, and LLPs. Visit the ISDS Capwiz page to send your message to the governor.


legislation , practice management , state of illinois ,

Permanent link  Tooth whitening kiosks and Senate Bill 290


Several members have contacted CDS recently about the proliferation of tooth whitening kiosks at malls, spas and even the airport. We just wanted to pass along that Senate Bill 290, now awaiting the governor's signature, amends the dental practice act as follows.

"Provides that a person practices dentistry, within the meaning of the Act, who takes impressions of human teeth or places his or her hands in the mouth of any person for the purpose of (i) applying teeth whitening materials or (ii) assisting in the application of teeth whitening materials. Provides that a person does not practice dentistry when he or she (i) discusses the use of teeth whitening materials with a consumer purchasing these materials, (ii) provides instruction on the use of teeth whitening materials with a consumer purchasing these materials, or (iii) provides appropriate equipment on-site to the consumer for the consumer to self-apply teeth whitening materials."
You can also track the status of this bill at the Illinois General Assembly's Web site.


Illinois , legislation ,

Unfortunately, these individuals do no properly represent dental professionals. The quality of the treatment and safety of the patient is in question.<br /><br /><a href="" rel="nofollow">Dental Thornhill</a>

Posted by: Dr. David Cheng ( on 05/16/2011

These places will find a way around this bill. They already don&#39;t place their hands in the patient&#39;s mouth, but rather instruct the patient in how to do it. The real problem is that the poor patient thinks these people are real dental professionals. <br /><br />Who is going to police this act if it is passed? There are tanning salons and other places that are doing this that will be a lot harder to police than an open place like a mall.

Posted by: Anonymous ( on 05/16/2011

Permanent link  Q andamp; A on the Minnesota dental therapist


The American Dental Association passed the following information along to state and component societies about the newly signed legislation in Minnesota creating a dental therapist.

After completing a bachelor's degree program, the dental therapist will be able to practice in underserved location and and perform procedures, including restorations and primary extractions with the indirect supervision of a dentist.

Below are answers to some of the commonly asked questions as provided by the ADA's State Government Affairs Department.

The Minnesota Dental Association has also created a catalog of links to news coverage on this legislation.

Q: How did this happen?

A: Two years ago proponents of the American Dental Hygiene Associations' Advanced Dental Hygiene Practitioner (ADHP) introduced legislation to create that position in Minnesota. As designed, the model provides for the ADHP to perform surgery without a dentist being on-site and with virtually no supervision.

The legislation gained momentum in the Senate, but an aggressive media and lobbying effort by the Minnesota Dental Association (MDA) stalled it in the House. The MDA strove to educate lawmakers about the shortcomings of the ADHP model. MDA built a coalition of oral healthcare providers to oppose the legislation and mobilized dental students and others to testify in hearings as well as attend lawmakers' local meetings to speak out on the ADHP issue.

A number of former hygienists who now are dental students were particularly effective in speaking to the dramatic differences between dental and dental hygiene education and training. To help shape communications efforts around these issues, the ADA conducted extensive qualitative and quantitative opinion research.

MDA offered a variety of more realistic proposals to improve access to care, including the Community Dental Health Coordinator (CDHC) as a more integrated member of the dental team and an alternative to the ADHP. Ultimately, the MDA and its allies created enough controversy to scale back the legislation dramatically to the creation of a task force charged with making recommendations about an Oral Health Practitioner (OHP) for the legislature to consider in 2009. However, even this legislation was a turning point-the question was no longer whether to create midlevel providers, but rather how to do so.

The task force included representatives from the MDA, the University of Minnesota School of Dentistry, the Minnesota State Colleges and Universities, the Minnesota Dental Hygienists Association, the Minnesota Board of Dental Examiners and the Safety Net Coalition (SNC).

Unfortunately, the task force was unable to reach consensus. With the political and legal wind assuring the creation of a mid-level provider, the MDA put its efforts into ensuring patient safety and keeping the dentist as the head of the dental team. The state society made the difficult decision to endorse the alternative model proposed by the University of Minnesota School of Dentistry. The dental school's plan provided for an integrated member of the dental team, educated in an accredited dental school, working with the supervision of a dentist. Any procedure permitted in the therapist's scope would be taught to the same standard as a dentist.

The OHP Task Force narrowly approved recommendations that closely mirrored the ADHP design, and sent its report to the legislature. The MDA, the dental school and others offered alternative reports and findings that staked out the principles of one standard of education, patient safety and an integrated dental team as opposed to the fractured model offered by ADHP or OHP.

With the start of the 2009 legislative session both the OHP and dental therapist models garnered legislative support. Looking to avoid conflict, legislators put both provisions into the same bills and appeared poised to pass them both. With that prospect, MDA undertook a print, radio and web ad campaign with support from the ADA State Public Affairs program to raise public and policymaker awareness about the lack of supervision and varying standards of education that led to patient safety concerns in the OHP model. In the wake of that campaign, the Senate considered an MDA-supported amendment to remove the OHP scope, supervision and education requirements and replace them with those of the dental therapist. While that amendment failed by a single vote, it was a far closer outcome than anyone had predicted and provided real momentum heading into the House of Representatives.

In the end, the House the Speaker decided to direct a negotiated settlement. Ultimately the result of that process very closely tracked the School of Dentistry model and the MDA principles.

Q: What exactly will the dental therapist do, and under what level of supervision?
A: The basic dental therapist will qualify for licensure upon graduation from a Bachelor's degree dental therapy program. The University of Minnesota School of Dentistry has stated that it will offer the program as of September 2009, but other institutions may develop them as well. A concern is that the Minnesota State Colleges and Universities system (MnSCU) which had originally agreed to host the ADHP program is exploring advanced placement for dental hygienists with a Bachelor's degree in their version of the dental therapy program (Bachelor's level). The extent, to which the Dental Board will authorize that process without placing the program at risk of not being approved by the Board, remains to be seen.

The Dental Board will grant a therapist license to a candidate who has successfully completed the program and passed a clinical exam, The therapist will work in a dental office with the indirect (on-site) supervision of a dentist, and will be able to provide a range of dental services for the underserved including restorations and extraction of primary teeth.

The supervising dentist must authorize any surgical procedures before treatment may commence. Further, the supervising doctor will be on site to deal with any complications or emergencies.

After practicing as a dental therapist for at least 2000 hours, a candidate may choose to pursue a two-year Master's degree in advanced dental therapy. Upon successfully completing that program and passing a clinical exam, an advanced therapist could practice in a separate site from the supervising dentist. However, any surgical procedure would still have to be specifically approved and authorized by the dentist prior to treatment. The advanced therapist also could extract permanent teeth with a mobility factor of +3 to +4, but only with preauthorization from the supervising dentist. By retaining a level of supervision by the dentist, the MDA has to the extent possible kept the dental team intact, with the dentist as the comprehensive leader of that team.

The law requires the dental board to report to the legislature in 2014 about the safety of dental therapists, the cost-effectiveness of the program and its impact on access to dental care.

Q: What about dental hygiene?
A: The dental therapist program excludes much of the dental hygiene scope of practice. Dental therapists will not perform prophys. The skill set required for a dental therapist is different than that of a dental hygienist.

Claims that the dental therapist law is a breakthrough for proponents of the ADHP model are overstated, to say the least. To become a basic dental therapist one must complete a dental therapy Bachelor's degree. Whether one holds a degree or license in another allied dental profession does not matter. Without the dental therapy degree, one cannot be licensed and cannot practice as a dental therapist. The requirements for admission to the Master's level program are completion of the Bachelor's level therapist program and at least 2,000 hours of practice as a therapist. While someone holding a different type of allied dental professional degree will be free to apply and enroll in either dental therapy program, they will have to complete the appropriate dental therapy degree to practice as a therapist.

Q: How will dental therapists be limited to caring for the underserved?
A: The law sets strict guidelines for the patient base therapists can serve and the areas in which they can practice, including:

  • Critical access dental clinics (which are operated by dentists who receive enhanced reimbursement from Medicaid because they treat a high volume of Medicaid patients);
  • The usual assisted living facilities, FQHCs, etc.;
  • A collaborative hygiene setting (although this would only apply to an advanced therapist, because a basic therapist could not perform surgical procedures with no supervising dentist on the premises);
  • Military and VA facilities;
  • Dental or dental therapy schools; and
  • Any other setting where at least 50 percent of the therapist's patients are among the following groups:
  • Enrollees of a state publicly funded health care program,
  • Having no private or public dental coverage and are at 200 percent FPL or below; or
  • The patients or practice is in a designated DHPSA.


access to care , legislation ,

need more hygienists.<br />Not more administrative dower without requirements of a nurse Dr or hygienist.<br /><br />sincerely<br />Dr. BDC<br />

Posted by: Brian ( on 05/16/2011