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Front Page » Education » Enough dentists, but where?

Enough dentists, but where?

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Written by on March 26, 2014

Enough dentists, but where?

While reports of an impending shortage of dentistry graduates have circulated, local experts said enough people are entering the field – but just not enough are practicing in rural areas.

“Everyone wants to say, ‘Oh, we don’t have enough dentists’,” said Dr. Terry Buckenheimer, president of the Florida Dental Association and a trustee for the American Dental Association. “But that’s not it.”

In Florida, the number of dentistry graduates is expected to increase by about 100 in 2016 when the Lake Erie College of Osteopathic Medicine, or LECOM, graduates its first class at its Bradenton campus, Dr. Buckenheimer said.

In 2012, 217 students graduated from University of Florida’s College of Dentistry and Nova Southeastern University’s College of Dental Medicine; in 2013, 216 graduated; and in 2014, 211 are scheduled to graduate, Dr. Buckenheimer said.

“We don’t think there’s a lack of dentists per se,” he said. But “there seems to be a mal-distribution of dentists in the state of Florida.”

According to an American Dental Education Association’s survey of a 2012 graduating class, 16.3% of seniors said they’re “very much” interested in treating the underserved, 23% said they’re “much” interested, and 37.5% said they’re “somewhat” interested.

“People coming out of school want to be employed, they don’t want to go to areas where people can’t afford dentistry,” said Dr. Bertram Ivan Moldauer, program director of the new Advanced Education in General Dentistry Residency Program at Larkin Community Hospital in South Miami. “Everyone wants to profit, wants to pay their loans, and they want to practice in high-income areas.”

The Larkin residency program was in part formed to address this issue.

Residents will be based in four South Florida community health clinics: the Dental Health Center at Jessie Trice Community Health Center Inc.; the Miami Beach Community Health Center; a Borinquen Medical Centers of Miami-Dade branch near Midtown; and a Community Health of South Florida Inc. branch in South Miami, Dr. Moldauer said. 

“We have to encourage the new generation to provide services to the underserved,” he said. “Everything is concentrated in the big metropolis.”

Larkin’s first class of 16 is expected to enroll in July.

The University of Miami Miller School of Medicine and the Jackson Health System have a two-year general dentistry residency, which enrolls 18, and a four-year oral and maxillofacial surgery program, which enrolls 16 residents and two fellows, said Dr. Robert Marx, professor of surgery and chief of oral and maxillofacial surgery at the University of Miami Miller School of Medicine and Jackson Health Systems.

Dr. Marx agreed that dentistry residencies provide services to the underserved, but he added that the underserved aren’t only people who can’t afford dental care.

“It’s people who have HIV, people who are incarcerated and people who have a medical compromise,” he said. “There’re people who have serious medical problems that the routine medical office is not equipped to handle.”

University of Miami and Jackson Health System residents service Jackson Memorial Hospital, Jackson South Community Hospital, the University of Miami Hospital and the Miami VA Healthcare System, he said.

Dr. Buckenheimer, of the Florida Dental Association, said that while some dentists may want to service areas in need, “it’s hard to take on a lot of Medicaid patients because the reimbursement rates are so low and you can’t support a business model.”

Aside from residencies, the dental community targets the problem through organized pro-bono events.

“It’s easier to do it through an organized event,” he said, “instead of doing it through Medicaid.”

 

2 Responses to Enough dentists, but where?

  1. Dentist in Park Ridge

    March 26, 2014 at 10:59 am

    The Chicagoland area sure has a lot of dentists. Really, any big city will.

  2. FDA

    March 26, 2014 at 2:29 pm

    FL Senate Interim Report 2012-127 states:
    p15.

    “Options and/or Recommendations:
    There is not a state-wide shortage of dentists in Florida and therefore there is no general need to recruit foreign-trained dentists or dentists from other states or jurisdictions. However, despite efforts by the Legislature to incentivize dentists to practice in rural areas and serve low-income individuals, a shortage in these areas is projected to continue. If the Legislature is interested in pursuing additional measures to increase the dental workforce in Florida, particularly to practice in rural areas or in public health settings and provide services to underserved populations, Senate professional staff recommends the following options:
    Dentists Licensed in Other States or Jurisdictions: Authorize Licensure by Credentials or Reciprocity
    Florida may become more competitive in its recruitment of dentists if the Board was authorized to determine which states have substantially similar licensing standards, including education and examination requirements, and the Board sought reciprocity agreements for licensure with these state dental boards. Licensure by credentials or reciprocity could also require the dentist to have been engaged in active practice for a period of time immediately prior to applying for licensure in Florida.
    Expand the Health Access Dental Licensing Program
    Authorize a dentist to obtain licensure through the health access dental licensing program if the dentist agrees to serve a certain percentage of Medicaid recipients or participate in the provider network of managed care entities participating in the Medicaid program.
    Offer Loan Forgiveness or Other Loan Incentives
    o Additionally, Florida may become more competitive in its recruitment of dentists in rural areas and may enhance Florida’s dental care for underserved populations if it offers a loan forgiveness program. The program could require dentists seeking loan assistance to serve in a rural area (the Panhandle or central, south Florida) and require dentists to serve a certain percentage of Medicaid recipients or participate in the provider network of managed care entities participating in the Medicaid program for a particular period of time. Considering the current lack of state resources, it may be beneficial to limit the number of dentists that may apply to the loan forgiveness program and target resources to areas with the most need for general dentists or specialists.
    o Furthermore, Florida could offer state-guaranteed low-interest loans, subject to available state funding, to dentists wishing to establish their own practice. Because dentists often have large student loans and, therefore, are not in a financial position to open their own practice, it may encourage more dentists to set up their practice in an underserved area, if the state would offer state-guaranteed low-interest loans for either a 10 or 15-year period for the purchase of a dental office and dental equipment. The dentists could be required to practice in the underserved area and serve a certain percentage of Medicaid recipients or participate in the provider network of managed care entities participating in the Medicaid program for the life of the loan. After completion of the loan payment, the dentist would become the owner of the facility and equipment without further obligation.”

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