In their quest to expand patient access to economical dentures by servicing the public directly, denturists have fought long, hard battles at the grass-roots level to legalize their profession as it is in many other countries. Despite limited manpower and financial resources, they've taken on the ADA and its powerful organized efforts to thwart denturism and now have the legal right to work independently and directly with the public in Arizona, California, Idaho, Maine, Montana, Oregon and Washington.
Those who oppose denturism argue that denturists lack the proper training and therefore provide substandard care. These opponents then gain public awareness by filing legal complaints against denturists practicing in states with no legislation. The ADA and state associations have also been successful in defeating recent legislation in Kentucky, which has been in the works since 2000, and in Wyoming where, despite support of the state's influential Silver Haired Legislature (a group of senior citizens elected by their peers at senior centers statewide), a bill languishes in the state's House of Representatives. Still facing an uphill battle, denturists continue to pursue legislation to both change existing laws and legalize the profession in additional states. In Kentucky, Rep. Thomas Burch--who sees legalization of denturism as an anti-poverty measure by making dentures more accessible to the state's many rural poor--plans to bring a bill back before the legislature this winter. A delegate from the Maryland Assembly will submit a bill in the next session.
The National Denturist Association (NDA) is assisting with the Kentucky and Maryland efforts. In addition to letter-writing and media campaigns, it has assembled a task force in its Legislative and Policy Division and is funding lobbying efforts in cooperation with state denturist associations. "We want no fight underfunded," declares President Paul Levasseur, LD, DD, MCDP.
In Arizona: The first state to legalize denturism in 1977, Arizona originally granted 30 denturists provisional certifications but issued no licenses in the ensuing 30 years. That's because the requirements for subsequent candidates to earn certificates included graduating from a two-year, in-state accredited institution, which did not exist at the time, nor does it exist now.
However, in 2007, the licensing board agreed to accept certification from any U.S.-accredited institution like the two-year denturism degree from Bates Technical College in Tacoma, WA. Bates also had plans to pilot an 11-month distance-learning program for denturists who hold degrees from other accredited non-U.S. institutions--such as Canada's George Brown University--to meet Arizona's requirement, but that has been tabled due to funding cuts.
Since the 2007 decision, two graduates of Bates have received licenses to practice in the state and 10 others are enrolled in the distance-learning program.
In California: In late 2004, California enacted its Complementary and Alternative Health Care Practitioners Act (CAHP) providing for unlicensed, self-regulated alternative healthcare practices including denturism, homeopathy and naturopathy. The statute gives California denturists a protective umbrella under which to practice, requires them to disclose their education--where it was obtained, course of study and degree--and prohibits certain restricted, mostly invasive, procedures, such as surgery or puncturing the skin, X-rays or administering drugs. Certifications offered by professional organizations that set their own educational and ethical standards are voluntary.
Immediately, the state denturist association in California stepped forward to certify denturists with a Doctorate of Medical Denturitry (DDM) degree. This is a four-year, non-accredited program offered by Mills Grae University in Montana. To date, approximately two dozen California denturists are in practice or setting up practice with California Medical Denturitry Association certifications.
"Since denturitry is a completely separate profession from dentistry and I have complied with the guidelines of the CAHP law, "I've practiced without any legal challenges for three years.
Many Bay area dentists refer 'removable' patients to me and I refer patients back to them for hygiene, fillings, crowns, extractions and implants. This is how the complementary system is supposed to work," explains Robert Storey, DDM, Advanced Denture Care in Daly City, California.
In Oklahoma: Denturists were protected by the state's alternative medicine laws until the passage of House Bill 2732. The bill, which was originally drafted for veterinary reform, included making practicing denturism a felony and the law went into effect on November 1, 2008. The state's denturists are now lobbying for repeal of the law and for legalization. The Oklahoma Dental Association has responded with calls to its members to contact their legislators and urge them to uphold the new law.
Underserved Populations in Need of Dentures
Denturism proponents believe denturists play a vital role in serving poverty-stricken populations around the world. To the malnourished whose teeth fail them at an early age, to the low-income men and women in job-training programs who would benefit from a healthy smile while trying to secure employment, to the victims of domestic violence who need to restore their smiles and self confidence, access to affordable dentures can have a life-changing impact.
Also underserved are patients suffering the debilitating effects of methamphetamine addiction, known as "meth mouth." Even limited periods of addiction can wreak havoc resulting in blackened, stained, rotting or crumbling teeth. According to a research study in France from 2003, intravenous heroin users also show high rates of rapidly progressive dental decay. The researchers concluded that dentures should be provided to intravenous drug addicts as part of their rehabilitation before attempting to reinsert them into work environments and independent living situations.
Ironically, in California, incarcerated women are prevented from access to addiction treatment and job training programs if they have any pre-existing health problems, including dental problems. With lack of access to dental care, these women often resort to pulling teeth to gain access to the rehabilitative programs, thereby undermining their ability to reenter the workforce.
Given that the 2007 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration showed little change in overall drug use rates in people 12 years and older, this is a clientele that is here to stay. For a 20-year-old recovering drug abuser, a chance for a new start through employment or school may hinge on access to dentures.
Bates Technical College in Tacoma, Washington: 253-680-7000; http://www.bates.ctc.edu
Collège Edouard-Montpetit in Longueuil, Canada: 450-679-2630
George Brown Toronto City College in Toronto, Canada: 1-800-265-2002 or 416-415-5000, ext. 4580; http://www.gbrownc.on.ca
Northern Alberta Institute of Technology in Edmonton, Canada: 780-471-7686; http://www.nait.ab.ca
Vancouver Community College in Vancouver, Canada: 604-443-8501; http://www.vcc.ca
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