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In a PFA-sponsored International Continuing Education Course held in London on 22 June 1998, then NIH Director Harold Slavkin (now USC School of Dentistry Dean) shocked listeners by telling them that by 2005 there would be a shortage of dentists. Dental schools all over the United States were closing due to rising costs and lower enrollments—Loyola’s Chicago College of Dental Surgery, Northwestern, Emory, Farleigh Dickinson, Washington University, Oral Roberts, to name a few that come to mind.
But as the country’s population moved West, a few States made plans to build their own dental schools —Colorado, Arizona, and Nevada.
Since our own Central Office is located in Las Vegas with the prospect of headquartering in the new UNLV dental school, we have paid a great deal of attention to its progress. A series of dental exhibits has been planned for the new UNLV facility. Dr. Ibsen has contributed to purchasing the “turn of the century” dental office of Dr. Zeller through the PFA. A midcentury dental facility is already prepared by our Secretary General Richard Kozal with PFA equipment donations and Foundation funding. And a modern dental office will be donated by an equipment supplier.
The Nevada Legislature, under the spearhead of our own Senator Ray Rawson, first approved the development of the UNLV dental school in 1999 as an answer to the need for dentists, particularly in Las Vegas—dubbed the fastest growing city in America.
A passing glimpse at the construction of the UNLV School of Dentistry
This concept was also supported by Nevada’s Higher Education System.
Recently, the Legislature established a Committee to Evaluate Higher Education Programs composed of six lawmakers, three members of the Board of Regents, and several other participants to review studies prepared by a consultant in deciding about further educational institutions for nurses, teachers, and dentists. The consultants, the National Center for Higher Education Management Systems of Boulder, Colorado, reported that Nevada’s number of dentists compared against the nation as a whole was actually higher.
The 2000 U.S. Census Bureau stated that Nevada had 41.5 employed dentists per 100,000 population, which was significantly higher than the national average of 32 employed dentists per 100,000.
The Committee Chairman, Senator Warren Hardy (R-Las Vegas), expressed surprise at the figures, but suggested that the raw data does not address the issue of how many dentists are appropriate.
Chancellor Jane Nichols went further to state that perhaps a dental school is not necessary. But she noted that other sources of information were used to justify the need for the new school and those need to be compared before making a final decision.
Two weeks later, Chancellor Nichols reported that the data presented earlier had not counted all the practicing dentists nationwide, and that Nevada does have a lower ratio of dentists to population. In her letter, as mentioned by news reporter Sean Whaley, she noted, “There is an alarming shortage of oral health care for a significant segment of the population in Nevada.”
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The data provided by the consulting firm came from the U.S. Bureau of Labor Statistics and excluded dentists in private practice. Nichols noted that most dentists are self-employed and thus were not counted in the labor statistics. She also commented that the ADA maintains data on all active dentists, some 168,000 in 2001. That establishes the ratio at 60.7 for every 100,000 population. According to the ADA, Nevada’s ratio is 39.2 dentists per 100,000 residents. The report from the Oral Health America National Grading Project 2003 gave the United States an overall “C” rating in dentist availability. In that report Nevada received an “F.”
The Nevada Board of Dental Examiners provided statistics that there were 41.5 dentists per 100,000 population.
But the respected Pew Health Professions Commission stated that there were 61 dentists nationally per 100,000 population, thus Nevada was below the national average. Those figures were confirmed by the American Dental Association as well.
Has anyone checked the figures from the National Institute of Health, which in 1998 first predicted a shortage of dentists nationwide by 2005?
Assemblyman Bob Beers (R-Las Vegas), a dental school opponent, is running against Senator Ray Rawson (R-Las Vegas) for his seat, stating, “that is certainly an expensive mistake if that is what it turns out to be.” (Reported by Sean Whaley of the Review-Journal Capital Bureau.)
When many of us started out in practice, we were given the figure that to be successful, an average dental load was 2000 patients. That amounts to 50 dentists per 100,000 population.
Currently, those of us attempting to acquire dental associates in our practice to be able to slow down as age creeps up on us are having an impossible time finding them. Those trying to sell their practices and retire are discovering the same problem.
If asked by questionnaire whether I was a practicing dentist, I would have answered in the affirmative. But I have cut back my hours in recent years to accommodate the PFA workload, enjoy my family more, and participate in more community activities now that I have worked up the chairs over the years. Perhaps I am that half dentist in the statistics.
In previous articles in Dental World, we have advocated a national open licensure, like the European Union has already. Several States are crying out for dentists to practice in their rural and underserved areas. California is one such reported State that has agreed to Licensure by Credentials, as well as others. This has been reported by the Academy of General Dentistry.
Statistics do not tell the whole story. How many hours does a dentist put in? How much time in the year does a dentist take off? How has the graying of the baby boomers started to affect tomorrow’s future of dentistry? Nobody has taken an accurate head count, but the reality of the situation is simply that there are not enough dentists. And within a decade, the situation is going to get worse. Some States do not even have a dental school. Where do you suppose they get their dentists from?
Nevada voters need to be aware of this and not make a political football out of building a much-needed school of dentistry—if not for student access from Nevada into the profession, at least for the rest of the country.
If Nevada finds that it has too many dentists, send them East. We need them if you do not. I will take two right now. They start Monday.
Senator Ray Rawson greeting President Kevin Roach and Vice President Howard Mark
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