Richard Gyles: Dental therapy — an innovative & collaborative solution to meet Florida’s needs

As a Fellow of the American Academy of Pediatric Dentistry, working with children and families over the past fifteen years, I have been in the unique position to witness the decreased quality of life vulnerable children experience due to lack of access to high-quality oral care.

In 2017, less than 40% of Florida Medicaid-eligible children received any dental service, meaning approximately 60% of eligible children lacked any dental services. As we have continually seen, lack of oral health reduces productive activities in school, work and home and decreases quality of life.

Over the past several decades, the number of dental school graduates has not kept pace with the growing United States population. In fact, Florida has 240 dental health professional shortage areas throughout the state and would need more than 1,250 dentists to remove the designation.

Further, the high cost of dental education and student debt are forcing dental school graduates to work in group practices rather than in community health dental practices, resulting in two times more dentists in urban areas compared to rural areas.

The American Academy of Pediatric Dentistry supports efforts to collaborate with other dental and medical organizations to study barriers to care and underutilization of available services. I fully agree we must find solutions to fix this glaring oral health need, which is why I support the Floridians for Dental Access coalition and authorizing dental therapists to practice in Florida.

As a pediatric dentist, I work with certified nurse anesthetists under the general supervision of anesthesiologists. One anesthesiologist with multiple nurse anesthetists is able to provide the same high-level anesthesia care for multiple children without the need for multiple anesthesiologists. By introducing a mid-level oral health provider, such as a dental therapist, who works under the supervision of a dentist, dentistry can do the same to relieve the lack of access to oral health care by increasing the workforce need to access preventable dental services.

Dental therapists can help meet the need of Florida’s growing population by establishing work practice guidelines that include employment in community health centers with an emphasis on rural counties.

More dental therapy programs will be joining the existing programs that have been graduating students over the past eight years.

I urge Florida to embrace this solution and allow more Floridians access to oral health care.


Dr. Richard Gyles is a Fellow of the American Academy of Pediatric Dentistry, the Pediatric Dental Director at Suncoast Community Health Centers, Inc. and the Associate Director for NYU Langone, Advanced Education in Pediatric Dentistry – Florida. He is also on medical staff at Tampa General Hospital and South Florida Baptist Hospital. Gyles is Board Certified by the American Board of Pediatric Dentistry and maintains membership and professional interest with the American College of Healthcare Executives, Dental Anesthesia, Orthodontics and Laser Dentistry.