WORKFORCE

The dental therapist pipeline is barely a drip

Dental therapists have been pitched as a potential solution to the labor shortage in dental, particularly for underserved communities. There’s just one problem: barely any are being trained. 

What’s happening: A growing number of states are creating license pathways for dental therapists—staff who work under a dentist’s supervision and typically handle everything a hygienist can do plus some basic dental procedures, like placing fillings.

• As of earlier this year, the American Dental Therapy Association (ADTA) counted 14 states that permit dental therapists to practice. 

Yes, but: States may be allowing dental therapists to practice, but very few people are actually taking them up on that offer. Only around 300 dental therapists are currently practicing nationwide, according to the executive director of the ADTA, and almost half of those are in Minnesota. 

• Minnesota authorized dental therapy in 2009, graduated its first students in 2011, and now has three of the country’s seven training programs, making it by far the most established market.

• Other states have struggled to build their own pipeline. In Oregon, for example, just 13 therapists received licenses in the two years after its 2021 law came into effect. Michigan created its dental therapist scope in 2018 but has since licensed just two practitioners.

• And there is no wave of new graduates coming: Only 38 people were enrolled in CODA-accredited dental therapy programs for the 2025–26 school year, down slightly from the prior year, according to ADA data.

Why it’s happening: The biggest bottleneck is training. Most states that allow therapists still have no local training program or have only recently spun one up. The ADTA lists only seven dental therapy programs in the country, three of which are in Minnesota.

• Entry requirements and job restrictions create more hurdles. Some states require a hygiene qualification as well. Others restrict where therapists can work and what patients they can serve.

• The ADA has also resisted efforts to expand licensing of dental therapists, arguing that the role compromises patient safety and diverts resources from existing dental training programs.

Why it matters: Unless there are dramatic changes in the training landscape, it seems unlikely that dental therapists will be of any help in relieving the industry’s staffing shortages. 

• Even if more training programs were to be established, it would still take years for new graduates to start entering the job market.

• At least one dental group is circumventing this bottleneck by building its own pipeline: Oregon’s Willamette Dental Group trained licensed hygienists as therapists while they continued working full time as part of a small pilot program.

Bottom line: For most DSOs, retaining hygienists and making full use of assistants remain more immediate options. Outside of Minnesota, being able to tap dental therapists at scale is still years away.