As of late 2024, 13 states have passed laws authorizing dental therapists to practice: Alaska, Arizona, Colorado, Connecticut, Idaho, Maine, Michigan, Minnesota, Nevada, New Mexico, Oregon, Vermont, and Washington. Each state sets its own rules for supervision, practice settings, and the procedures dental therapists can perform, so the profession looks quite different depending on where you are.
All 13 States With Dental Therapy Laws
Minnesota was the first state to authorize dental therapists in 2009, and the list has grown steadily since. Here’s every state that currently recognizes the profession, along with the key details of how each one structures it:
- Alaska: Recognizes dental therapists, with a model that grew out of tribal health programs serving remote communities.
- Arizona: Recognizes dental therapists statewide.
- Colorado: Recognizes dental therapists statewide.
- Connecticut: Recognizes dental therapists statewide.
- Idaho: Recognizes dental therapists statewide.
- Maine: Requires dental therapists to work under the direct supervision of a dentist in limited practice settings.
- Michigan: Allows dental therapists to practice under dentist supervision in specific settings, including correctional facilities, school-based health centers, and federally qualified health centers.
- Minnesota: Requires a written collaborative management agreement with a dentist, giving therapists relatively broad autonomy.
- Nevada: Dental therapists practice under a written agreement with a supervising dentist.
- New Mexico: Requires dental therapists to first be licensed dental hygienists who then complete a dental therapy education program.
- Oregon: Requires both dentist supervision and a collaborative agreement outlining the specifics of the therapist’s practice.
- Vermont: Dental therapists practice under the general supervision of a dentist, meaning the dentist does not need to be physically present.
- Washington: Authorization is limited to dental health aide therapists providing preventive services on tribal reservations and in Indian health program facilities.
How Supervision Varies by State
The biggest practical difference between states is how closely a dentist must oversee the dental therapist’s work. States generally use three levels of supervision: direct, indirect, and general. Under direct supervision, a dentist must be physically present in the office and available to check the therapist’s work. Indirect supervision means a dentist is somewhere in the facility but doesn’t need to be in the same room. General supervision is the most flexible, allowing the dental therapist to provide care even when the dentist isn’t on-site, as long as there’s an agreement in place.
Maine sits on the more restrictive end, requiring direct supervision. Vermont sits on the more flexible end with general supervision. Most states fall somewhere in the middle by requiring a collaborative practice agreement, a written document that spells out which procedures the therapist can perform, what level of oversight applies, and how the dentist and therapist will communicate about patient care. Minnesota’s collaborative management agreement model has been influential, serving as a template for several states that followed.
Some states also restrict where dental therapists can work. Michigan, for example, limits practice to settings like school-based health centers, correctional facilities, and federally qualified health centers, all places that serve populations with limited access to traditional dental offices. Washington’s law is the most narrowly drawn, applying only to tribal health settings.
What Dental Therapists Actually Do
Dental therapists fill a role between a dental hygienist and a dentist. They handle many of the routine procedures that make up the bulk of everyday dental care, freeing dentists to focus on more complex cases. The specific list of allowed procedures varies by state, but the core scope typically includes:
- Fillings: Preparing teeth and placing fillings to treat cavities and minor damage.
- Preformed crowns: Placing stainless steel or other preformed crowns, and recementing crowns that have come loose.
- Simple extractions: Removing teeth that don’t require surgical intervention.
- Pulp treatments on baby teeth: Performing pulpotomies (removing damaged pulp tissue from primary teeth) and pulp capping procedures to protect the nerve in a tooth.
- Temporary restorations: Fabricating and placing temporary crowns and restorations.
- Preventive care: Providing the same preventive services dental hygienists offer, including cleanings and fluoride treatments.
- Suture removal: Taking out stitches after oral surgery performed by a dentist.
- Mouthguards: Fabricating athletic mouthguards and soft occlusal guards.
What dental therapists cannot do is equally important. They don’t perform complex surgical extractions, place implants, design orthodontic treatment plans, or handle other advanced procedures that require a dentist’s full training. Think of them as handling the bread-and-butter dental work that accounts for the majority of patient visits.
Why States Are Adding Dental Therapists
The push to authorize dental therapists is driven by a straightforward problem: tens of millions of Americans live in areas without enough dentists. Rural communities, tribal lands, and low-income urban neighborhoods are hit hardest. In many of these areas, the nearest dentist is hours away, or the wait for an appointment stretches months. Children in underserved communities often go years without seeing a dental provider at all.
Dental therapists require less training time than dentists, typically completing a master’s-level program of about three years rather than the four years of dental school plus residency. That shorter, less expensive training pipeline means more providers can enter the workforce faster and are more likely to practice in the communities that need them most. Alaska’s program, which has placed dental therapists in remote Native villages since the mid-2000s, demonstrated that this model could bring care to people who previously had almost none.
The economic logic works for dental practices too. A dentist who delegates routine fillings and extractions to a dental therapist can see more patients overall, focus their own time on complex procedures, and keep the practice financially viable in areas where reimbursement rates are low.
States Considering Dental Therapy
The 13 states with active laws represent a growing trend, not a finished map. Several additional states have introduced dental therapy bills in recent legislative sessions, and advocacy from organizations focused on oral health access continues to push the issue in statehouses nationwide. If you’re in a state not listed above, it’s worth checking your state legislature’s current session for any pending bills, as the landscape shifts year to year.