摘要：Disparities in dental health care that characterize poor populations are well known. Children suffer disproportionately and most severely from dental diseases. Many countries have school-based dental therapist programs to meet children’s primary oral health care needs. Although dental therapists in the United States face opposition from national and state dental associations, many state governments are considering funding the training and deployment of dental therapists to care for underserved populations. Dental therapists care for American Indians/Alaska Natives in Alaska, and Minnesota became the first state to legislate dental therapist training. Children should receive priority preference; therefore, the most effective and economical utilization of dental therapists will be as salaried employees in school-based programs, beginning in underserved rural areas and inner cities. The 2000 report of the surgeon general Oral Health in America noted, What amounts to “a silent epidemic” of oral diseases is affecting our most vulnerable citizens—poor children, the elderly and many members of racial and ethnic minority groups.1(p1) This persistent epidemic has not been alleviated by continuation of the present dental care delivery system. A significant factor contributing to the inability of children to obtain adequate dental care is the shortage of accessible dentists. 2 Expansion of the dental workforce to include dental therapists offers the potential for improvement. More than 14 000 dental therapists practice in more than 54 countries throughout the world, including New Zealand, which originated the concept; Australia; Canada; the United Kingdom; and, most recently, the United States, in Alaska and Minnesota. 3–5 High school graduates are trained in a 2-year program to provide preventive and restorative dental care, usually for children. In some countries training is being extended to 3 years to incorporate both dental therapy and dental hygiene, and to provide treatment of adults as well as children. 6,7 Dental therapist programs have been studied extensively in a number of countries, and the quality of care, which includes preventive and restorative treatment for more than 90% of school-aged children through high school, has been consistently documented to equal care provided by dentists. 8–10 School-based dental therapists are salaried public health workers, and the overall cost of providing care to children in schools is thus significantly lower than the cost of private dental care. 11
