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involved evaluating the work of practicing therapists. Fiset (2005) performed the first evaluation of Alaskan DHATs. While he did not report figures, he stated that all of the cavity preparations and restorations he observed “met the standard of care” established. Three other studies are more rigorous. Calache et al. (2009) evaluated the work of therapists treating adults in New South Wales, Australia, and Jones et al. (1981) and The General Dental Council (1966) evaluated the work of therapists treating children in the United Kingdom. Though samples in the first 2 were small, in all 3 studies, examinations were conducted post-treatment, and in all cases less than 10% of the procedures evaluated were judged to be unsatisfactory (just 5.4%, 2.5%, and 9.2%, respectively). According to all 3, this indicated an acceptable level of work. It is perhaps worth noting that of the nearly 2 dozen studies reviewed, all but 4 (3 of which evaluated the new Alaska DHAT program) were conducted over 20 years ago. This is largely a result of a consensus outside of the United States with regard to the clinical competence of dental therapists (e.g., Jones et al., 1981). The current review supports this conclusion. Of the 23 reports addressing the technical competence of dental therapists (or specially trained hygienists) performing irreversible dental procedures, all but 2 concluded that dental therapists performed the procedures assessed at an acceptable level. And all that directly compared their work with that of dentists or dental students found that they performed at least as well. Of the 2 studies drawing negative conclusions, one (Gruebbel, 1950) exhibited clear methodological shortcomings and biases. The other (Redig et al., 1973), a more careful study, actually found that the New Zealand school dental nurses performed rather well, but nevertheless concluded that a similar program would not be suitable for California. Rarely in the scientific literature, in fact, do we find such an overwhelming consensus based on empirical research. The fact that methodologies differ, and the studies span such a long time period and come from several countries, can only increase confidence in the conclusion that, rather than representing a different standard of care, dental therapists simply represent a different provider. This review does not speak to the expected impact on access that the introduction of this provider model might have or its economic viability in the United States. However, it is clear that therapists’ ability to safely and competently perform the limited set of irreversible procedures that fall within their scope of practice is no longer a point of contention, at least from an empirical standpoint. Given this, and given the strong support among various governmental and non-profit entities for introducing dental therapists to the U.S. workforce, future research efforts might be better focused on the economic feasibility/sustainability of this model within the U.S. context, the acceptability of these types of providers to the American public, and the impact such providers might have on access to care. Acknowledgments The authors thank Anne Gwozdek and David Nash for comments on an earlier version of this article. This research was generously supported by a grant from the Nokomis Foundation. The authors declare no potential conflicts of interest with respe In the U.S., many people have access to the best oral health care in the world, yet millions are unable to get even the basic dental care they need. Individuals who are low-income or racial or ethnic minorities, pregnant women, older adults, those with special needs, and those who live in rural communities often have a much harder time accessing a dental provider than other groups of Americans. Tooth decay is almost completely preventable, yet when people do not see a dental provider, they do not get the preventive services and early diagnosis and interventions that can halt or slow the progress of most oral diseases. The issue of lack of access to dental care is extremely serious because