Integration of dental therapists in safety net practice increases access to oral health care in Minnesota.

Objectives: This study evaluates the impact of introducing dental therapists (DTs) into Children's Dental Services (CDS), a large non-profit organization in Minnesota. The aim is to assess the effect of DTs in improving access and reducing dental care costs in Minnesota by analyzing the trends in dental care delivery and procedures performed by CDS dentists and therapists.

Methods: Using 2009 to 2021 data from CDS, the study compares trends in patient volume, types of procedures, salary data and payments by dentists, DTs, and registered dental hygienists (RDH). Return on investment (ROI) trends are calculated using salary and revenues for each provider type.

Results: After introducing DTs at CDS and implementing mobile clinics, the number of patients served and volume increased steadily, demonstrating increased access. DTs provided an increasing proportion of fluorides, sealants, and extractions through 2020. Interestingly 2021, there was a decrease for DTs, possibly due to Covid related workforce shortages. ROI analysis showed that DTs' ROI dramatically rose, eventually surpassing dentists, while RDHs maintained a constant ROI. Dentists' ROI also initially increased after adopting DTs in the practice.

Conclusion: Integrating DTs at CDS improved access by expanding mobile clinics, increasing patient volume, and redistributing procedures, while demonstrating a positive return on investment. Results suggest that adopting the DT model may be a promising practice for other organizations seeking to improve access to dental care, increase operational efficiency, and boost the dental care team's ROI.