January 3, 2018

What is a Dental Health Aide Therapist (DHAT)?

We’ve heard the question, “What is a dental health aide therapist?” more often lately. Simply put, it’s a way to expand access to oral health care. The concept isn’t exactly new. However, it is only beginning to catch on here in the US.

A dental health aide therapist (or DHAT) is a midlevel dental care provider.

A dental health aide therapist (or DHAT) is a midlevel dental care provider.

DHATs (or dental therapists) are midlevel dental care providers. Like medical physician’s assistants, they work as part of a team. In addition, they generally provide both preventive and restorative services.

The dental health aide therapist or DHAT model does have some critics. However, more states are making the DHAT role a part of their oral health systems. Let’s look at what it is, how it got started, and what kind of training it entails.

DHAT Duties and Qualifications

Typically, DHATs provide clinical dental services. They usually assist in dental prevention and dental health education. DHATs work as “extensions” of their supervising dentists. In addition, they may also work with a dental team. The routine services they provide help prevent and treat oral disease.

Before working as a DHAT, one must meet federal requirements through study with an accredited institution. Certification is also required, to ensure knowledge of general dentistry. Topics of study include disease prevention, dental health education, and basic restorative, preventive and surgical procedures.

How the Dental Health Aide Therapist Model Started

New Zealand created the DHAT model about a 100 years ago. The goal was to help improve oral health for school-aged kids. More recently, the system has gained traction in areas like Alaska. In such areas, access to dentists can be severely limited. And that can lead to severe problems.

In 2009, for example, Alaska had a serious “epidemic of oral disease,” according to dentist Dane Lenaker.  “A 2008 investigation of oral disease in Alaska Native children found that among children aged 4-5 years and 12-15 years…, 87% and 91%, respectively, had dental caries,” Lenaker reported. Compare that to  35% and 51% of U.S. children with cavities in those age groups.

“Among children from the Alaska villages,” Lenaker continues, “those aged 4-5 years had a mean of 7.5 dental caries, and those aged 12-15 years had a mean of 5.0, compared with 1.6 and 1.8 dental caries in same-aged U.S. children.”

Alaskans adopted the DHAT model after repeated failures to recruit and retain dentists. Today, over 50 countries use the model, Lenaker notes. A review of the model worldwide, which looked at over 1000 studies and reports, found it expands access to safe and effective oral health care.

Dental Health Aide Therapist Training

Interest in DHATs has grown since the launch of Alaska’s DHAT program. Today, Minnesota, Maine, Vermont, and Washington have all passed laws allowing the practice. Tribal communities in the Pacific Northwest also employ DHATs. In addition, other states are considering legislation in favor of the model.

In Alaska, tribal communities recruit students for training as DHATs. The students complete a rigorous program. They receive education equivalent to three academic years in just two years. Next, they complete “preceptorships” with dentists. After training is complete, the state certifies them to work offsite under general supervision.

DHATs can consult with their supervising dentists remotely. They refer patients to dentists when treatment services are outside of their scope. Because they practice in areas very like the ones where they grew up, they understand the community members’ customs and needs.

According to Lenaker, the first class of DHAT students in Alaska got their training in New Zealand. They began practicing in Alaska in 2006. More recently, DHAT training was available through a University of Washington School of Medicine program based upon the New Zealand model. The UW’s DHAT program moved to Alaska in 2017.

Read next: Top Dental News 2017

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