What is a Midlevel Provider?

ASDA identifies a midlevel provider as an individual, who is not a dentist with four years of post-collegiate education (three years in the case of University of the Pacific School of Dentistry), who may perform irreversible procedures on the public. They have some dental training, but do not hold a DDS or DMD degree.

Midlevel dental providers could include any of the following:

• Dental therapist
• Dental health aide therapist
• Advanced dental therapist

Some states have adopted legislation permitting midlevel providers to practice in that state. Many states cite barriers to care issues and reducing oral health disparities as primary reasons midlevel providers are necessary. However, data has not demonstrated that midlevel providers help reduce untreated dental decay.

ASDA Policy

ASDA’s C-2 policy on dental providers states that the dentist is the only dental provider that should perform the following functions:

1. Diagnosis and treatment planning
2. Prescribing work authorizations
3. Performing surgical/irreversible dental procedures
4. Prescribing drugs and/or other medications

What Has ASDA Done?

• Watch ASDA’s Fast Facts video on midlevel providers here.

• ASDA’s Advocacy 101 webinar digs into key issues affecting the profession, including midlevel providers. Watch the recording here.

• ASDA’s 2019 midlevel provider advo-cast featured two experts who focused on midlevel legislation and the role of Community Dental Health Coordinators. Watch the recording here.

• During the 2017 Advocacy Month, ASDA hosted a panel for three dental professionals: a public health dentist, a dental therapist and a community dental health coordinator. The panelists discussed their place in the dental health care community. Watch the recorded webinar online. 

Current Legislation

Be sure to check ASDA Action for any midlevel provider bills that ASDA may be monitoring on the state level.

ASDA Resources

• ASDA keeps its members abreast of current legislation and other news about the issue of midlevel providers through ASDA’s monthly advocacy newsletter, the Advocacy Brief.
• ASDA created a PowerPoint explaining the association's stance on midlevel providers and ASDA’s efforts to address the barriers to care issue. Download the presentation to share this information with your colleagues.
• ASDA’s midlevel provider talking points outline the association’s stance and provides background information on the issue. This is a great resource for students who may be speaking with key stakeholders.
• “Funding the Fight for Midlevel Providers,” Contour, November/December 2017 

Other Resources

• AGD: Midlevel Providers
• ADEA Interactive Legislative and Regulatory Tracking Map
• AAOMS White Paper on Midlevel Providers 
• AAPD, “Analysis and Policy  Recommendations Concerning Midlevel Dental Providers”
• ADA Workforce Statement: "Breaking Down Barriers to Oral Health for All Americans: Repairing the Tattered Safety Net"
• “ADA Scientific Study Finds Surgical Midlevel Providers Do Not Reduce Overall Rates of Dental Decay”
• ADA: “About Community Dental Health Coordinators” 
• ADA comment on the Kellogg Foundation Report, "A Review of the Global Literature on Dental Therapists"