Unfortunately, this saga has continued to evolve with the dental hygiene community offering an advanced dental therapist program, thus eliminating the oversight of the dentist and allowing for access to total dental care. In an effort by the Minnesota Dental Society to curtail this movement, it was suggested to the legislature that no independent practice could survive under a total reimbursement model. The legislative response was mTOR inhibitor to allow such practitioners to accept up to fifty percent of their patients as full payers. So, why should Prosthodontists have concern? It should be apparent. First and foremost,

we should be concerned about the quality of care provided for patients. Meanwhile, other states are looking at enacting this

type of care to remedy their access-to-care needs. I refer you to a California Dental Association Journal article of May 2009, “Issues Faced by Community Health Centers,” by Jane Grover, DDS, MPH. Her graphs from the US Census Bureau (2000) depict the active dentists per population ratios, and Minnesota is not as underserved with dentists as 18 other states are. Some dental schools, such as Loma Linda University School of Dentistry, have felt compelled to form an evaluation committee so they may have a knowledge-based response to the pressure of such change. Second, aside from the important issue of quality care, the dynamics of increasing the unrestricted, licensed dental practices of dental therapists will be enormous. Such impact

will certainly change the competitive RXDX-106 cost edge of the DDS and DMD, as these providers will be availing the entire range of services from oral surgery to implant management. Should Prosthodontists surmise that these evolving mid-level care providers pose a severe compromise the professional aspect of dentistry? In time, will dentistry become a true commodity-based trade? As this mid-level community develops, is it not probable that general dentists, as we know them today, will be expanding even more into the specialty fields of endeavor with fervor in order to survive … an encroachment we have already witnessed 上海皓元 in our own specialty? This is a challenge that the Prosthodontic community cannot afford to let pass. Prosthodontists remain well-positioned as we, above any other dental specialty, have the training and experience in the critical areas of diagnosis, treatment planning, and complex dental care and, as a specialty, have the greatest involvement with clinical procedures as they are carried forth in general dentistry. We need to respond accordingly: First, we must keep the quality of care issue at the forefront. Recognize that if there are legitimate (state-licensed) practitioners entering the field of dentistry, we must assist with the evolution of evidence-based dental outcomes relative to both favorable and unfavorable patient care.