By ROLF LOWE
Wachler & Associates, P.C.
In 2018 the Michigan Legislature introduced and passed Public Act 463 of 2018 providing a pathway for licensure as a dental therapist, with the legislation becoming effective in March of 2019. Nearly seven years later the Michigan Department of Health and Human Services (MDHHS) and Michigan Department of Licensing and Regulatory Affairs (LARA) are finally seeing the fruits of their labor to increase access to dental care to Michigan residents begin to blossom, with the state’s first dental therapist becoming licensed and starting to practice in the Upper Peninsula in early 2026. Michigan is one of fourteen states that currently authorizes the practice of dental therapy.
Dental therapists are licensed providers under Michigan’s Public Health Code, Public Act 368 of 1978, and are regulated by LARA’s Bureau of Professional Licensing (BPL) and the Michigan Board of Dentistry, with pathway to licensure coming to fruition in 2021. Dental therapists are trained and licensed to provide routine dental care, which includes patient examinations, the development of an individual treatment plan cleanings and filings.
The services of a dental therapist are provided under the supervision of licensed Michigan dentist. The supervision requires a written practice agreement between the dental therapist and the supervising dentist. The dental therapist may only provide services to patients that are within their scope of practice, are authorized by their supervising dentist and provided according to written protocols or orders that are established by the supervising dentist. A supervising dentist is limited to supervising four dental therapists.
A written practice agreement between a dental therapist and a supervising dentist must include the following nine elements:
- The services and procedures and the practice settings for those services and procedures that the dental therapist may provide, together with any limitations on those services and procedures;
- Any age-specific and procedure-specific practice protocols, including case selection criteria, assessment guidelines, and imaging frequency;
- Procedures to be used with patients treated by the dental therapist for obtaining informed consent and for creating and maintaining dental records;
- A plan for reviewing patient records by the supervising dentist and the dental therapist;
- A plan for managing medical emergencies in each practice setting in which the dental therapist provides care;
- A quality assurance plan for monitoring care, including patient care review, referral follow-up, and a quality assurance chart review;
- Protocols for administering and dispensing medications, including the specific circumstances under which medications may be administered and dispensed;
- Criteria for providing care to patients with specific medical conditions or complex medical histories, including requirements for consultation before initiating care; and
- Specific written protocols, including a plan for providing clinical resources and referrals, governing situations in which the patient requires treatment that exceeds the dental therapist’s capabilities or the scope of practice as a dental therapist.
Dental therapists may practice in traditional office settings, as well as non-traditional settings including schools, mobile clinics and community health centers.
One of the limitations Michigan currently faces in expanding this specific healthcare workforce is that there currently is no dental therapy program in the state, and there are only five dental therapy programs in the nation. However, change is coming for Michigan as Ferris State University is developing Michigan’s first dental therapy program with assistance from MDHHS development through a federal Health Resources and Services Administration oral health workforce grant. MDHHS and other stakeholders hope that by developing and nurturing the expansion of dental therapy into Michigan they can address many of the identified dental care shortfalls, including reducing waiting times, expanding access in a cost-effective manner, providing services in unrepresented areas, easing pressure on existing providers and improving cultural and linguistic representation in care.
For additional information on dental therapy, or any of the 26 health professions currently regulated by the Bureau of Professional Licensing, please contact Rolf Lowe of Wachler & Associates at (248) 544-0888 or rlowe@wachler.com.