Scope-of-practice fight looms over worsening dental access crisis

Floridians are struggling to access basic dental care, and trendlines suggest the challenge will only intensify if policymakers don’t act, according to data from the Well Florida Health Planning Council^[1] and Floridians for Dental Access^[2].

The organizations point to persistent shortages of dentists — particularly in rural counties — as a primary driver of rising costs and declining access. Many residents forgo routine care, allowing otherwise preventable conditions to progress until emergency treatment becomes the only option.

In 2024, more than 146,000 Floridians sought help at emergency departments for dental pain and infection, a 25% increase since 2021. More than 4,000 required hospitalization. Hospital charges tied to dental issues rose 77% over the same period, pushing the overall tab close to $1 billion. The true cost is likely far higher, since untreated dental problems can spiral into chronic conditions such as diabetes.

Florida’s dentist-to-population ratio stood at 52.4 per 100,000 residents as of August — well below the national average of 59.5 cited by the American Dental Association^[3]. The numbers are even starker outside major metros: two-thirds of Florida’s rural counties have 10 or fewer dentists, and Glades County has none.

Similar to other scope-of-practice battles in health care, the state’s rapid population growth is expected to strain access further. Without changes, advocates say, either other trained providers will need to help fill the gap or patients will continue to bear the pain.

One proposal is to authorize dental therapists, mid-level professionals who, akin to physician assistants in medicine, can perform basic procedures such as fillings and simple extractions under the supervision of a licensed dentist. Dental therapists complete CODA-accredited programs and must pass the same licensing exam as dentists for the procedures they are authorized to perform.

Floridians for Dental Access, the American Children’s Campaign along with the Florida Dental Hygienists’ Association and more than 400 other groups, support the change. Legislation cleared the House during the 2025 Session but stalled in the Senate amid opposition from the Florida Dental Association^[4], which stands alone on the other side of the battle.

Advocates counter that dental therapy has been safely implemented for decades in dozens of countries and more than a dozen states.

“The pushback from the FDA ignores the soaring pain and suffering and doesn’t make any sense,” said American Children’s Campaign^[5] President Roy Miller. “… They would be supervised by dentists. And it would be voluntary on whether a dentist would add them to their practice as well. There are many dentists in Florida who support dental therapy, and the FDA certainly doesn’t speak for them.”

With committee weeks starting Oct. 6 and the 2026 Session opening Jan. 13, dental therapy is expected to be back on the agenda — and with it, the broader question of how Florida will address its worsening oral health crisis.

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