Information for Current and Aspiring Dental Therapists

Michigan requires all dental therapists to have graduated from a CODA-accredited dental therapy program or one the Michigan Board of Dentistry determines is substantially equivalent.

For dental therapists who graduated from dental therapy programs that were not accredited by CODA at the time of their graduation, they can request to have their education program reviewed by the Board of Dentistry (see instructions on how to do so) to determine whether they will accept it.

All dental therapists must have completed at least 500 hours of patient care under the direct supervision of a dentist as a part of their education.

Michigan requires all dental therapists to have passed the CDCA-WREB-CITA dental therapy exam or an examination that is substantially equivalent as determined by the Michigan Board of Dentistry. That exam includes a:

• Two-part competency-based clinical exam

• Manikin restorations exam

• In-person clinical exam

• Computer-based didactic exam

Dental therapists must work under the supervision of a dentist with whom they have a written practice agreement. The specific supervision level for a dental therapist is set by the supervising dentist via the practice agreement and can vary by procedure.

Written practice agreements are a collaboration between dental therapists and their supervising dentist(s) and create a plan for how the dental therapist will practice. The plan generally includes standing orders and protocols dental therapists must follow and any restrictions on scope, settings, patient selection, or supervision the supervising dentist requires.

You can find out more information and see a sample written practice agreement in the Michigan Primary Care Association’s dental therapy employer manual. Dental therapists may supervise up to three dental assistants and two dental hygienists if permitted by the practice agreement.

Michigan sets some limits on where dental therapists can practice. Dental therapists can work in:

• Any health setting within a dental health professional shortage area;

• A Federally Qualified Health Center, a school-based health center, a local health department, a tribal health clinic, a hospital, or a correctional facility; or

• Any other clinic or practice setting where at least 50% of their patients are covered by Medicaid, are low-income and uninsured, or have a disability or chronic condition that creates a significant barrier to receiving dental care.

In addition to working in traditional clinics and dental practices, dental therapists can bring care directly to patients, either with a mobile clinic or with portable equipment, and provide care in community settings like schools, Head Start centers, group homes, and long-term care facilities.

Clinics in Michigan are eager to hire dental therapists! The Michigan Primary Care Association maintains a job board for positions in health centers, but you may also find opportunities posted on broader job sites like Indeed.

The Department of Licensing and Regulatory Affairs (LARA) has published a guide to applying for dental therapy licensure.

Under Michigan law, dental therapists may perform the following procedures:

Diagnostic Procedures:

• Performing an oral evaluation and assessment of dental disease and developing an individualized treatment plan if the supervising dentist has given the dental therapist written authorization to provide the services and reviews the patient records as provided in the written practice agreement

• Identifying oral and systemic conditions that require evaluation or treatment by dentists, physicians, or other health care professionals and managing referrals

• Comprehensive charting of the oral cavity

• Administering and exposing radiographic images

Preventive Procedures:

• Providing oral health instruction and disease prevention education, including nutritional counseling and dietary analysis

• Dental prophylaxis including subgingival scaling or polishing procedures

• Applying topical preventative or prophylactic agents, including fluoride varnish, silver diamine fluoride and other fluoride treatments, antimicrobial agents, and pit and fissure sealants

• Fabricating athletic mouth guards

Medications and Anesthetics:

• Dispensing and administering via the oral or topical route nonnarcotic analgesics and anti-inflammatory and antibiotic medications as prescribed by a health care professional

• Applying desensitizing medication or resin

• Administering local anesthetic and nitrous oxide analgesia

Restorative and Surgical Procedures:

• Pulp vitality testing

• Emergency palliative treatment of dental pain related to a care or service described in this subsection

• Changing periodontal dressings

• Preparation and placement of direct restoration in primary and permanent teeth

• Fabrication and placement of single-tooth temporary crowns

• Preparation and placement of preformed crowns on primary teeth

• Indirect and direct pulp capping on permanent teeth

• Suturing and suture removal

• Placement and removal of space maintainers

• Simple extraction of erupted primary teeth

• Nonsurgical extractions of periodontally diseased permanent teeth with tooth mobility +3. However, a dental therapist shall not extract a tooth for any patient if the tooth is unerupted, impacted, or fractured or needs to be sectioned for removal

Other:

• Minor adjustments and repairs on removable prostheses

• Performing other related services and functions authorized by the supervising dentist and for which the dental therapist is trained

• Performing any other duties of a dental therapist that are authorized by the board by rule