Partnerships Needed to Strengthen Dental Workforce
By Ryan Dunn
Imagine if your local hospital employed more doctors than nurses. The ratio would likely turn the efficiency of care on its head, not to mention create the kind of fiscal havoc that could put internal accounting departments into wholesale cardiac arrest.
Even so, a version of that scenario is a reality in many dental offices in Virginia. A Virginia Dental Association analysis this year revealed the Commonwealth has more dentists than dental hygienists, even as each dentist is allowed to supervise up to four dental hygienists.
The uneven ratio means many dentists can’t practice a preventative model of dentistry, and patients are left with small problems that become more serious, more expensive, and, in some cases, life-threatening in between appointments. More than a third of Virginians have had a permanent tooth removed because of tooth decay or gum disease, which has impacts on health, nutrition, ability to apply for a job and their personal well-being.
We have empty dental hygiene bays across Virginia while many of these patients are ending up in hospital emergency departments that aren’t equipped to treat the root causes of dental pain.
The sad irony is that Virginia has the largest concentration of general dentists in the country. Access to timely dental care should be widely available.
There are many contributing factors to the shortage of dental hygienists in Virginia, but they boil down to the policy decisions that we make as a Commonwealth. Last year Virginia had 483 newly licensed dentists and we graduated only 135 hygienists from our community college and university-based programs.
Our challenge is not student interest. Our allied dental programs have eight times the applicants as they do available slots for admissions. That’s a more selective admissions process than UVA.
Our challenge is the bottleneck in program capacity, which directly impacts patient care. HRSA estimates that on a percentage basis, Virginia’s shortage of dental hygienists is even more acute than our nursing shortage, with an immediate unmet need for 950 more hygienists.
These two year programs at community colleges take students from a median pre-enrollment income of less than $20,000 to a median income in Northern Virginia upwards of six figures.
A recent poll of dentists by the American Dental Association’s Health Policy Institute found that since the pandemic, half of dentists have personally taken on duties previously assigned to other team members due to staffing challenges. The situation prevents them from practicing at the top of their license and limits their ability to care for more patients.
Fortunately, progress is being made thanks to a coalition of partners led by the VDA to ease workforce shortages and boost access to oral health. The work means more people will access quality preventative and restorative care while more Virginians find meaningful and well-paying careers.
VCCS Chancellor David Dore laid out his vision for the future of healthcare education at the Virginia Chamber of Commerce Healthcare Conference June 5, including a planned expansion at the Northern Virginia Community College’s Medical Education Campus and sharing resources more strategically between programs. These are exciting and welcome developments.
Lawmakers are helping, too. The new state budget includes critical funding for Virginia Commonwealth University’s School of Dentistry, which will help boost hygiene class sizes while creating state-of-the-art classrooms to support the dental workforce.
Virginia is among the first seven states to approve the Dentist and Dental Hygienist Compact, which will reduce barriers for licensure across state lines. It’s an important change, particularly for active-duty military families who live in Virginia and have family members working in the dental field. Thanks to the compact, these professionals have one more option that will enable them to avoid licensure delay while meeting oral healthcare needs in our communities.
Ongoing initiatives continue to help connect people to dental positions as well. A program through Virginia’s Community Colleges called G3 helps cover the tuition of select in-demand fields like dental assisting and hygiene for individuals with a household income of less than $100,000.
We’re creating new pathways for dental careers at a time when there’s never been more interest. Dental hygienists are among the top 20 in-demand jobs in Virginia that you can qualify for with a two-year associate degree, with the highest median income among the fast-growing health professions. For students or individuals looking to change careers, that’s a compelling opportunity.
We owe it to our patients to give more students the opportunity to pursue these careers and more must be done to make up for years of disinvestment in these essential healthcare roles. Virginia for a variety of reasons is an attractive place to practice dentistry and it’s one of the top destinations for in-migration of early career dentists. If we want to allow those dentists to practice at the top of their license and address the long waiting lists for hygiene appointments throughout Virginia, we need to address the bottleneck at our dental hygiene programs.
What’s encouraging is that we’re making great strides thanks to public and private partnerships. We’re thankful for the leadership of Virginia Chamber of Commerce CEO Barry DuVal, our business community, higher education teams and legislators who continue to see the value in strengthening access to oral healthcare in Virginia by expanding access to these education programs.
Oral healthcare is essential, and Virginia’s dental community is committed to helping Virginians get the care they need and deserve even as we work together to attract and train the next generation of dental professionals to support this critical work. Working together, the outcome will be something worth smiling about.
Ryan Dunn is CEO of the Virginia Dental Association. The Virginia Dental Association is a professional organization representing dental professionals and the practice of dentistry in the Commonwealth of Virginia. VDA member dentists employ 25,900 Virginians, contributing $1.46 billion in direct payroll in the Commonwealth. Learn more at vadental.org.
