title: Safety Net Care and Midlevel Dental Practitioners: A Case Study of the Portion of Care That Might Be Performed Under Various Setting and Scope-of-Practice Assumptions.
abstract: OBJECTIVE
  We sought to determine the proportion of dental care provided at safety net-type clinics that might be performed by midlevel practitioners.
  
  
  METHODS
  Data were obtained on 157,328 procedures performed in 2012 at the clinics associated with a Midwestern dental school. Based on procedure codes, we determined the overall proportion, as well as the proportion of visits and patients' care, that could have been performed by 3 types of practitioners.
  
  
  RESULTS
  Overall, 48% to 66% of all procedures could have been performed by a midlevel dental practitioner. Nearly half of all visits, and roughly a third of all patients, could have been entirely cared for by a practitioner trained in prophylaxis and with evaluation capabilities. Such practitioners could handle roughly 80% of the visits at the community-based clinic and more than half of the visits at the hospital-based clinic.
  
  
  CONCLUSIONS
  A midlevel practitioner with training in prophylaxis has the potential to alleviate much of the burden on the dental safety net because much of the need among vulnerable populations falls well within their scope of practice.
authors.affiliation: Elizabeth Phillips and H. Luke Shaefer are with the School of Social Work, University of Michigan, Ann Arbor. Anne E. Gwozdek is with the Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Phillips
authors.affiliation: Elizabeth Phillips and H. Luke Shaefer are with the School of Social Work, University of Michigan, Ann Arbor. Anne E. Gwozdek is with the Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Gwozdek
authors.affiliation: Elizabeth Phillips and H. Luke Shaefer are with the School of Social Work, University of Michigan, Ann Arbor. Anne E. Gwozdek is with the Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan.
authors.forename: H Luke
authors.initials: HL
authors.lastname: Shaefer
mesh_terms: D003727:Dental Auxiliaries; D003756:Dental Hygienists; D005260:Female; D006801:Humans; D007347:Insurance, Dental / Q000191:economics; D008297:Male; D008484:Medicaid / Q000191:economics; D019982:Organizational Case Studies; D011636:Public Health Dentistry / Q000191:economics*; D064876:Safety-net Providers / Q000191:economics*; D012575:Schools, Dental; D013335:Students, Dental; D014481:United States; D000078329:Workforce