Predicting the Future of Dentistry

The future of dentistryLast 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.

Survey Finds Dental Licensing Laws Archaic

Survey Finds Dental Licensing Laws Archaic61% of dentists surveyed do not like the current U.S. dental licensing system and would like to see a universal system of licensure by credentials.

Many of the dentist respondents find the U.S. dental licensing laws archaic and restrictive to trade.

A Pennsylvania dentist wrote, “I am licensed in 4 states and it is truly a nightmare process! From finger printing to accounting for every month of a 35 year career. The system is broken.”

Only 20% of the dentists like the dental licensing system as it stands, while another 19% are somewhat satisfied, but would still like to see changes.

Though dental license requirements vary from state to state, all applicants for dental licensure must meet three basic requirements; an education requirement, a written examination requirement and a clinical examination requirement, as outlined on the ADA website.

Here’s what dentists had to say about the current dental licensing system —

“A doctors/dentist license should be valid by reciprocal recognition in all states.” (California dentist)

“We should be able to practice wherever we want to.” (New York dentist)

“Reciprocity should be nationwide as long as your record is clean.” (General dentist)

“If a dentist is Board Certified by a ADA recognized specialty, he/she should be able to practice that specialty in any state without taking a general dental licensing examination as that individual has attained the highest level of professional scrutiny!” (Pennsylvania oral surgeon)

“There should be a well-designed, comprehensive, yet difficult, national clinical board examination that all states accept. All foreign dental grads should be required to complete the last two to three years of dental school prior to taking any board exam.” (Virginia dentist)

“If you’re competent to practice in one state, you’re competent to practice in any state. Other than that, it’s power and politics and fear that you are not good enough to succeed in a competitive marketplace.” (Massachusetts dentist)

“It’s all politics. If a student passes the clinical exams from an accredited American dental school, he or she should have the freedom and opportunity to live and practice anywhere they desire. The market will decide if there’s too many dentists in an area.” (Kansas dentist)

“There should be one exam taken for clinicals that is good in all states upon passing the individual jurisprudence exam for each state. I took and passed 4 different regional or state exams when I got out of school, but many states would still require me to take another exam to practice in their state because they don’t have reciprocity.” (General dentist)

“We need one universal system for dental licenses, similar to medical doctors.” (Illinois dentist)

“My wife is a registered nurse and she’s mobile.” (Texas prosthodontist)

“We should have one exam that covers all states.” (Arizona dentist)

“I feel that if you have passed national Boards and any state board, there shouldn’t need to be any further testing. Its not like there’s any state that wants to pass substandard dentists! I lecture all over the US and internationally, and every once in a while, do hands on courses in other states at other doctor’s offices. I am not allowed to demonstrate on patients in any state I don’t have a license in. I have to demonstrate indirectly, walking the licensed dentists through procedures (that they may never have previously done) on patients that have presented for the course. It is an absurd situation.” (Illinois dentist)

“I recently retired from my NY practice of 42 years and moved to North Carolina where I wanted to practice part-time. The choices I had forced me to be retested on Jurisprudence and a sterilization/infection control exam. The entire process took well over a year. I had to be fingerprinted, obtain dental school scores, etc. I finally ended up with a limited volunteer license which allows me to volunteer my time at one of the state clinics. If I had wanted to get a regular license I would have had to pay $3500 with the assurance from me that I would use the license within one year or forfeit it. Can’t there be a simpler way for a retire dentist to volunteer his time?” (Retired dentist)

What are your thoughts on the current dental system of licensure by states?

What have you experienced because of state licensing?

Getting One Step Closer to Universal Licensure for Dentists

Health Access Dental LicenseFlorida’s governor hopes to increase access to dental care among underserved populations.

How does he hope to accomplish this? By allowing out-of-state dentists to perform dentistry in health access settings (state clinics, federal health centers, educational institutions, etc.). So on January 1, a new license was created in Florida: the health access dental license.

This license allows dentists not licensed in Florida to practice there without getting a full Florida dental license. To be eligible, dentists must have been actively practicing for at least the past five years or since graduating from dental school.

Many dentists will be delighted to have the opportunity to practice in Florida. Most dentists are licensed by state, so it can be difficult for doctors to practice elsewhere. Since Florida is a much sought-after retirement destination, many dentists wish they could head to the Sunshine State for a semi-working retirement. But licensing requirements have kept them away.

Here’s how the application begins:

“Health access settings” means programs and institutions of the Department of Children and Family Services, the Department of Health, the Department of Juvenile Justice, nonprofit community health centers, Head Start centers, federally qualified health centers (FQHCs), FQHC look-alikes as defined by federal law, and clinics operated by accredited colleges of dentistry in this state if such community service programs and institutions immediately report to the Board of Dentistry all violations of s. 466.027, s. 466.028, or other practice act or standard of care violations related to the actions or inactions of a dentist, dental hygienist, or dental assistant engaged in the delivery of dental care in such settings.

Read Florida’s licensing requirements

Universal Dental Licensure: Dentists Want It (VIDEO)

The clear majority of American dentists want one license that would let them practice their profession in any of the 50 states.

Only 16% of dentists surveyed support the current system of regional or state-by state licensure – and many of them live in states like Florida or California.

Read more: Dentists Eager for National Reciprocity


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