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HPI comments on dental workforce study

March 06, 2015

By Craig Palmer

Recent government projections of dental supply and demand "merit some discussion," the ADA Health Policy Institute said March 6 in a research brief commenting on the workforce analysis.

"Zooming out to the big picture, analyses like HRSA's [Health Resources and Services Administration] and HPI's dentist workforce projections, through a strong micro-data empirical approach, shed important light on how the supply of dentists will evolve in the coming years," the Health Policy Institute said. "HRSA's analysis attempts to go one step further and models the future demand for dentists, concluding that demand will grow faster than supply."

"Assessing current and future provider adequacy is both conceptually and empirically challenging," the HPI said. "It requires modeling labor market choices of dentists, dental school enrollment levels and demand for dental care. It also requires a good understanding of barriers to dental care." The most important barriers to dental care are not supply related, the HPI brief said.

HRSA's National and State-Level Projections of Dentists and Dental Hygienists in the U.S., 2012 to 2025 presents state-by-state estimates of the supply of and demand for dentists and dental hygienists but excludes dental assistants "as data on dental assistant supply are unreliable in the data set used in this study."

Among HRSA's key findings:

  • "Nationally. Increases in supply will not meet the increases in demand for dentists, which will exacerbate the existing shortage."
  • "All 50 states and the District of Columbia are projected to experience a shortage of dentists."

The HRSA analysis concludes that "changes in oral health delivery and in health systems may somewhat ameliorate dentist shortages by maximizing the productivity of the existing dental health workforce."

"HRSA has developed a very useful empirical model," said ADA Chief Economist Marko Vujicic, Ph.D. "However, a critical assumption is that dental care utilization patterns will remain constant through 2025 and, in my view, this is inconsistent with the best available evidence."

"The data suggest the dental care delivery system in the U.S. has the capacity to absorb more patients," Dr. Vujicic said. "In fact, there is compelling research to show that, in general, the main barriers to dental care have little to do with the availability of dentists."

Future research should focus on analyzing the dental market in smaller geographic areas and on better understanding the drivers of demand for dental care, the HPI brief said. The Health Policy Institute is engaged in research initiatives in partnership with other academic and government agencies to contribute to this effort.