By Michelle Tirado

A shortage of conventional dentists in Indian Country has forced lawmakers to seriously consider an unconventional — and highly controversial — solution: dental therapists, people who can perform many procedures that dentist do but with a fraction of the education and at a fraction of the cost.

Days before Christmas, the U.S. Senate approved an amendment to its healthcare reform bill, which now has rolled into it the reauthorization of the Indian Health Care Improvement Act. It includes a provision that opens the door for the expansion of dental therapy programs by allowing alternative dental health care provider demonstration projects.

There are presently only two states where dental therapists practice: Alaska, where they serve Alaska Natives, and Minnesota, the only state that has sanctioned them.

With proponents and opponents within the Senate, the provision approved reflects a compromise. It allows for dental therapy projects only if they are authorized by state law. But it also allows pilot programs requested by tribes or tribal health organizations that would not have to comply with state laws.