Is there a shortage in the oral healthcare industry? From dentists to dental hygienists and assistants, many states feature underserved areas that are desperate for a quick and efficient solution to the problem.
According to the October issue of AGD Impact, the newsmagazine for the Academy of General Academy (AGD), the most recent statistics from the Health Resources and Services Administration report that 20 percent of the United State's population reside in Health Professional Shortage Areas. Also, a 2002 Workforce Study by the American Dental Association (ADA) revealed that 37 states consider their current supply of practicing dentists to be lacking in one or more regions in the state.
Experts are at odds at whether there is a shortage or maldistribution that is creating the problem.
"The manner in which the government agencies have determined dental shortage areas has come under a good deal of criticism," says Myron J. Bromberg, DDS, chair of the AGD Council on Dental Care. "It's not a surprise that there was a decline in dentists between 1991 and 1998. In the 70s and 80s, the dental profession was impacted by an oversupply of dentists-thanks to government grants to dental schools. In the 90s, the ratio started evening itself out and now is approaching a more reasonable number."
"There's no doubt that dentists do not care to migrate to certain regions," says Dr. Bromberg. "This does not indicate a shortage of dentists, but rather a maldistribution of dentists. There are shortages in the country and that issue must be dealt with, but increasing the number of dentists does not resolve the problem. Dentists will still not gravitate to certain areas."
Some involved in the debate believe that reshaping the oral health care tier is the answer. The American Dental Hygienists' Association (ADHA) passed a resolution in July 2004 to create an advanced dental hygiene practitioner position. Similar to the nurse practitioner position that was created in the 1960s, a dental hygiene practitioner would have an expanded role in treating patients.
"We are encouraged by the successful evolution of the nursing field and by the achievements certain states have made in expanding the role of the dental hygienist...we don't see the traditional role of the dental hygienist changing," says ADHA president Helena Gallant Tripp, RDH, "We're looking at this as an additional role. We know that the number of dentists gradually is decreasing while the number of hygienists is increasing. We're looking for a long-term solution."
Two states, Arizona and Nevada have answered by opening dental schools in the last two years. A third, this one in rural Southwestern Virginia, is expected to open in 2007.
Access to care remains the core of the debate. Whether it is a maldistribution or shortage of oral healthcare workers, the numbers indicate that the access issue continues to get more serious.
"Even if there was a system in place to allow all people access to care...I still think there would be a shortage," says Ms. Tripp.
