About Dental Therapy
What is Dental Therapy?
Dental therapists are credentialed (licensed or certified) oral health providers who provide preventive and routine restorative care, working as part of a dental team.
They increase access to care by practicing in community-based settings, including Tribal health systems, rural clinics, and underserved communities.
What Dental Therapists Do?
Dental therapists are trained to provide common, person centered, high-need services, including:
- Exams and preventive care
- Fillings and basic restorative procedures
- Simple extractions of primary (baby) teeth
- Oral health education and disease prevention
They work under the supervision of a dentist, similar to how physician assistants work in medicine.
Why Dental Therapy Matters
Millions of people in the United States still face barriers to oral health care due to:
- Geographic isolation
- Cost
- Workforce shortages
Dental therapy is a proven, evidence-based solution that helps:
- Expand access to care
- Reduce wait times
- Bring services directly into communities
A Proven Model
Dental therapy has been used globally for over 100 years, starting in New Zealand.
In the United States, dental therapists have:
- Practiced in Alaska Tribal communities since 2004
- Delivered high-quality, safe care
- Helped expand access in rural and underserved areas
Today, dental therapy is authorized in multiple states and Tribal systems and continues to grow.
Education & Training
- Dental therapy education is grounded in nationally recognized accreditation standards for patient safety and quality care.
- Programs accredited by the Commission on Dental Accreditation follow established criteria for clinical training, supervision, and competency—ensuring alignment across the oral health workforce.
- ADTA supports continued growth of high-quality education programs and transparent, accessible pathways that reflect the needs of communities and the evolving oral health system.
Where Do Dental Therapists Work
Dental therapists practice in settings that need care the most:
- Tribal health systems
- Community health centers
- Rural and remote clinics
- School-based and mobile programs
Their role is designed to meet patients where they are. Dental therapists are for every community, and every setting.
Impact
Research and real-world implementation show that dental therapy:
- Expands access to care
- Maintains high standards of safety and quality
- Improves efficiency of the dental team
- Supports a more equitable oral health system
Dental therapy is a safe, effective, and community-centered solution to improving access to oral health care in the United States.
Overview of Dental Therapy in the United States
1970s–1990s
Early Interest but Slow Adoption
The United States first explored dental therapy in the 1970s, when federal health agencies recognized growing oral health workforce shortages—especially in rural and Tribal regions. Regulatory and political barriers prevented widespread implementation. For decades, communities continued to face barriers to affordable dental care, with disproportionate impacts on Indigenous, immigrant, and low-income populations.
2000s
Indigenous Leadership and the First U.S. Dental Therapists
In the early 2000s, dental therapy in the United States began through Tribal self-determination. Alaska Native communities learned of dental therapy and sent community members from rural villages in Alaska to the University of Otago in Dunedin, New Zealand to complete the two-year dental therapy educational program there. These students then returned to provide oral health care in their home communities in rural Alaska.
In 2007, the Alaska Native Tribal Health Consortium (ANTHC) launched the nation’s first dental therapy educational program to address the chronic lack of dental providers in Alaska Native communities. Dental Health Aide Therapists (DHATs) trained through a rigorous, competency-based model, providing preventive and routine restorative services under dentist supervision. Other countries have dental therapists practice as independent dental providers.
The impact was immediate: communities saw reductions in tooth decay, improved access to routine care, and fewer emergency extractions. The success of the Alaska model became a catalyst for nationwide policy change.
2010s
Expansion Across States
Inspired by Alaska’s outcomes, other states began to authorize dental therapy:
- Minnesota (2009) – Became the first state to authorize dental therapists statewide and create educational programs accredited by CODA (Commission on Dental Accreditation).
- Maine (2014) – Expanded opportunities for dental therapists to serve rural and underserved residents.
- Vermont, Arizona, Michigan, Nevada, and Idaho (mid-2010s–early 2020s) – Passed legislation recognizing dental therapy and establishing clinical practice pathways.
Several Tribal nations, including the Lower Sioux, Swinomish, and others, authorized dental therapy through Tribal sovereignty even before surrounding states enacted enabling laws.
2020s
Growing Recognition and Integration
By the 2020s, dental therapy gained momentum nationwide as states focused on health equity, rural access, and prevention-based dental care. Key developments include:
- Growing Tribal authorization across Indian Country
- Emerging university-based training programs accredited by CODA
- Integration into community health centers and safety-net systems
- Recognition from national organizations, including the National Indian Health Board, Pew Charitable Trusts, Community Catalyst, and several public health associations
Today, more than a dozen states have passed enabling legislation or Tribal authorization, and many more are actively exploring the model.
Looking Forward
The history of dental therapy in the United States is still being written. As more states, Tribal nations, universities, and community partners adopt this proven adaptive dental provider, dental therapy is poised to play an increasingly central role in transforming equitable oral healthcare access for future generations.