Last week we talked about restrictive licensure laws and how dentists want universal licensure. Now let’s start predicting the future!

The real problem is that there is a shortage of dentists that will become more acute over time. According to Harvard’s Dr. Chester Douglass, DMD (see his presentation), there were over 5,700 dental graduates per year in the early 1980s, and only 4,700 in 2007. We’ve lost over 1,000 dentists a year, some 20% of the pool!

Not to mention that our population is now one-third larger. Currently, Dr. Douglass reports, 600-800 more dentists graduate than retire each year… but this is projected to change in 2014. That means that in 5 years, dentistry will have negative growth, even as the population continues to increase.

My suggestion: Now is the time to put your kid in dental school!

The licensure issue will depend on the availability of dentists in that state, which is only going to get worse as the Baby Boomers retire. It's already difficult to attract an associate in more rural areas, let alone one who'll commit to the practice and buy you out.

It's no surprise that Maine and Minnesota have more open rules. (Maine offers Canadian dentists licensure by credentials, and Minnesota will grant guest licenses to dentists from neighboring states.)

And it's also no surprise that Florida and Hawaii are among the most restrictive, offering neither licensure by reciprocity nor by credentials. The only other states where that's true are Nevada and Delaware. (Why Delaware is holding back, I don't know!) Oh, and the US Virgin Islands.

Almost all other states offer licensure by credentials, except for a few that only license dentists by reciprocity agreement: Massachusetts, Mississippi, Pennsylvania, and Washington DC.

Universal licensure will eventually becomes easier. National reciprocity (in whatever form it takes) won't happen quickly, but states will have little choice as the number of dentists decreases and demand for dental care increases.