About the Dental Therapist specialty
A dental therapist sits on the same team as a dentist and a dental hygienist, but occupies the middle ground between them. Like a hygienist, they take X-rays, polish teeth, and counsel patients on oral hygiene. Unlike a hygienist, they can also fill a cavity, place a stainless steel crown on a child’s tooth, or pull a loose baby tooth (and, in some states or at the advanced tier, a loose permanent one), procedures usually reserved for a dentist. Every dental therapist works under some form of dentist oversight, though exactly how much varies by state and by the therapist’s own certification level.
Training runs at least three academic years of full-time postsecondary study, the floor set by the Commission on Dental Accreditation’s Accreditation Standards for Dental Therapy Education Programs, in place since 2015. What a graduate is trained to do and what a state lets them do are not the same thing, though; each state’s practice act grants its own procedure list, often narrower than the training. Coursework covers biomedical science and oral anatomy alongside supervised clinical practice in both prevention and restorative treatment, not prevention alone. Licensed dental hygienists, who already hold at least an associate degree from a CODA-accredited program, are often granted advanced standing that shortens the additional coursework. After graduating, candidates sit a written exam and a state jurisprudence exam before a state dental board issues a license; there’s no single national board exam the way there is for dentists or hygienists.
Where the license exists
Minnesota created the role first, authorizing dental therapists by statute in 2009 and splitting it into two tiers: Dental Therapist, and Advanced Dental Therapist for those with additional graduate-level training who can work under a dentist’s remote supervision instead of needing one on-site. At least 14 states have since passed similar authorizing laws, among them Alaska, Washington, Vermont, Maine, Michigan, and Arizona, but passing a law and training graduates aren’t the same thing. Accredited programs currently graduate dental therapists in just five states: Alaska, Minnesota, Oregon, Washington, and Wisconsin. Alaska’s version grew out of dental health aide therapists trained to serve remote tribal communities, certified through the tribal health system rather than a state license, and it predates most state licensure by years. Where someone lives, or which tribal health system serves them, still largely determines whether they’ll ever be treated by one.
Dental therapist vs. dental hygienist vs. dentist
A dental hygienist completes a two- to three-year CODA-accredited associate program, passes the National Board Dental Hygiene Examination, and is licensed to prevent disease (scaling, polishing, sealants, fluoride) but not to cut or remove tooth structure. A dentist trains far longer: four years of dental school for a DDS or DMD, usually after a bachelor’s degree, including the Integrated National Board Dental Examination and a clinical licensure exam, and can diagnose and treat any oral condition independently, including procedures outside a dental therapist’s scope, such as root canals and surgical extractions. The dental therapist’s three years of training land in between, adding specific restorative and minor surgical procedures on top of a largely preventive scope, always delivered under a supervising dentist’s authority rather than independently.
Sources
- coda.ada.org
- health.state.mn.us
- doh.wa.gov
- americandentaltherapyassociation.org
- ada.org
- adha.org
- revisor.mn.gov
- revisor.mn.gov
By the NPI Portal editorial team · Reviewed and updated 2026-07-10