Winter 2016

Our Professional Future

110420_5332_thomas021.JPGGreetings! I was recently invited by Massachusetts State Sen. Harriette Chandler to speak before the Joint Committee on Public Health on proposed legislation that seeks to establish an advanced dental hygiene practitioner level of practice. I did not speak either for or against this legislation, and I submitted no written testimony. However, any program proposing to educate additional members of the dental team should be done in accordance with the recently approved Commission on Dental Accreditation standards for such programs and in a dental school environment.

In response to questions, I said I considered it possible such a program could be developed at Tufts School of Dental Medicine within two years. As there has been some misinterpretation about my comments, I want to take this opportunity to set the record straight and address issues related to workforce and program development at Tufts.

First, workforce expansion: In 2000, the landmark “Oral Health in America: A Report of the Surgeon General” noted that prevention measures have resulted in marked improvements in oral and dental health for most Americans. However, it also highlighted profound disparities in the oral health of our citizens, amounting to a “silent epidemic of dental and oral diseases” affecting vulnerable populations, including the poor, and particularly children and elders.

Since that report, the access-to-care issue has been discussed by a variety of constituencies both within and outside our profession. Although there are many factors influencing access to care, one of the responses has been to expand the dental workforce through increased enrollment of dental students. Since 2000, 12 new dental schools have been opened, with still others planned. Enrollment has increased from 4,200 dental students in 2000 to 5,800 in 2015—a 40 percent increase. This is still fewer students than we enrolled in 1978 (6,300), despite a 44 percent increase in the U.S. population. There is continuing debate as to whether we need more dentists: The federal Health Resources and Services Administration argues that we do, whereas the American Dental Association Health Policy Institute (HPI) says that unless demand for dental services increases significantly, the current workforce is sufficient. However, because HPI data also show that only 42 percent of our population over age 65 received a dental visit in 2012, as did less than 48 percent of children, it would appear there is still considerable unmet need.

Second, a program in two years: There is no doubt that any dental school could develop a new program in a two-year period, not counting time for its accreditation. However, we have had no discussions at Tufts or with any other school about creating such a program and have no plans to do so. We have no capacity; our resources are fully invested in our current programs.

Summary: The dental profession is facing many challenges. We are concerned about the environment our graduates will enter—how it might change over the course of their careers and how we can provide appropriate curriculum and clinical experiences while they are at Tufts. In the past, the essence of practice did not change for many years; today, it is impossible to predict how the practice environment might change in just the next five years.

These challenges affect all of us, although the impact differs depending on whether you are in practice or in education. The Surgeon General’s report exposed the oral health issues this country is facing. We in dental education must work closely with our colleagues in organized dentistry to address these challenges, and we must be innovative and courageous. If we do not lead, we will be forced to follow.

Huw F. Thomas, B.D.S., M.S., Ph.D.
Dean and Professor of Pediatric Dentistry

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