Independent Practice for Denturists:
A Way to Provide Safe Dentures
At a Lower Cost to Consumers

Somewhere between a quarter and a half of the population will at some time during their lives be faces with the need to have their natural teeth removed and replaced with dentures. At best, this is an unpleasant experience. It can also be an expensive one. The dentures alone can cost $700 or more.

While it may not be possible to relieve people of the pain of undergoing this experience, it may be possible to reduce the cost. There is reason to believe that a significant reduction in the cost of dentures, and thus the cost of dental care, could be realized by having dentures provided by independently practicing denturists as well as by dentists. Currently in Michigan, dentists are the only dental professionals allowed to provide dentures directly to consumers. Denturists are dental professionals trained in the process of fabricating and fitting dentures but who currently are not allowed to provide services directly to the public.

The purpose of this paper is to examine the issues surrounding independent practice for denturists and to suggest changes in the state laws and regulations which govern the provision of dentures.

The Need for Denture Services

Although one would hope that the future need for dentures would be eliminated by improved oral hygiene and technological advancements, such a possibility appears remote at this time. The loss of natural teeth is most often the result of periodontal disease. Recent studies seem to indicate that there are different bacteria that cause different types of periodontal disease.1 These diseases lead to the destruction of bone and tissue surrounding the teeth, thereby promoting caries and, eventually, loss of support for the natural teeth. Inflammation of the gums is sometimes a precursor of periodontal disease and makes it difficult to remove the placque and bacteria surrounding the teeth. This creates a favorable environment for the development of periodontal disease. Some studies have shown a continuous decrease in bone support around teeth as people age, independent of tooth brushing and oral hygiene habits, and it has been suggested that it may not be possible to prevent or control the disease successfully.2

1 American Dental Association, "Strategic Plan: Report of the American Dental Association SpecialCommittee on the Future of Dentistry," July 1983, p. 17.

2 Meskin, Lawrence H., Martens, Lesile V., and Katz, Barbara J., "Effectiveness of Community Preventive Programs on Improving Oral Health," Journal of Public Health Dentistry.
Vol. 38, No. 4, Fall 1978, p. 307.