How Many Will We Need?
Greetings! The annual meeting of the American Dental Education Association (ADEA) that took place in Denver this spring marked the culmination of a year during which I had the privilege of serving as chair of the ADEA Board of Directors. I have been involved with this association throughout my career and as a result have gained a valuable perspective on many aspects of dental education and, in particular, the interdependent relationship between dental education and the practice of dentistry.
Our profession has served the oral health of the nation admirably—most Americans enjoy good oral health. This reflects well on our educational programs, demonstrating that the training our students receive is well-suited to their practice experience. However, our profession is also facing some significant challenges that are not only affecting the practice of dentistry but our educational programs, too.
In 2000, the U.S. Department of Health and Human Services published “Oral Health in America: A Report of the Surgeon General.” Several themes emerged from this report, including the fact that oral health is integral to general health and that one cannot be healthy without good oral health. But while the report noted that prevention measures had resulted in marked improvements in the nation’s oral and dental health, it also highlighted the “profound and consequential” disparities in the oral health of our citizens, amounting to a “silent epidemic of dental and oral diseases.”
Our profession is facing some significant challenges that are not only affecting the practice of dentistry but our educational programs, too.
Some population groups, including the poor of all ages, are particularly vulnerable, especially poor children and poor seniors. The lack of access to care was cited as “highlighting the oral health problems of disadvantaged populations and the effects on their well-being.”
In the intervening 15-plus years, the access-to-care issue has been addressed by a variety of constituencies both within and outside our profession. Academic dentistry’s answer has been to graduate more dentists by opening new dental schools (14 since 2000, with at least two more planned) and by expanding class sizes in existing schools. In 2000, approximately 4,200 students were enrolled in U.S. dental schools; in 2015 that number increased to more than 5,800. These numbers still do not reach the number we enrolled in 1977 (6,301), despite the U.S. population experiencing a 45 percent increase in the same time period.
Given recent reports from the Centers for Disease Control and Prevention that 23 percent of children ages 2 to 5 had caries in their primary teeth and that the rate of untreated tooth decay in primary teeth among children ages 2 to 8 is twice as high for Hispanic children and non-Hispanic black children compared with non-Hispanic white children, it’s clear that access to care is not being adequately addressed.
What impact will this have on the number of dentists we’ll need in the future? We have long debated whether this issue is one of undersupply or maldistribution. The discussion continues. A federal Health Resources and Services Administration analysis of the future supply and demand for dentists predicts that increases in the number of dentists will not meet demand. In contrast, the American Dental Association’s Health Policy Institute maintains that unless demand for dental services increases significantly, the current workforce is able or perhaps over-able to meet demand.
With these thoughts in mind, how do we ensure that dentistry continues to be one of the most desirable professions? How do we manage our applicant pool? As always, I welcome your thoughts on these issues by phone (617.636.6636) or email: firstname.lastname@example.org.
Huw F. Thomas, B.D.S., M.S., Ph.D.
Dean and Professor of Pediatric Dentistry