" we were colleagues ten years ago now we are competitors"

The purpose of this site is to show that many dentists are underutilized and there is maldistribution of Dentists in the USA. Follow this link to fill out a survey regarding Dental Manpower I can be contacted at drdkmacleod@gmail.com

10/20/17 Cost is a major barrier for people who skip dental visits

By Theresa Pablos, DrBicuspid.com associate editor

The statistics come from newly released data from the 2015-2016 National Health and Nutrition Examination Survey (NHANES). The survey is conducted by the CDC Center for Health Statistics and is designed to provide nationally representative data about the health status of children and adults in the U.S.

According to the new survey results, 16% of people who needed a dental visit in 2015-2016 couldn't get one. The overwhelming majority listed cost, followed by insurance not covering the procedures they needed. Having a dentist who was too far away was one of the lesser cited reasons for forgoing dental care.

The data also showed that the majority of U.S. residents see a dentist at least once per year. About half of Americans surveyed visited the dentist every six months, followed by 16% who visited annually. About 7% of the children and adults surveyed had never visited the dentist.

Practice ownership is declining

Marko Vujicic, PhD JADA 148(9) http://jada.ada.org September 2017

05/22/17 Oral Health Forum In California Features Vujicic, Others.

Dr Bicuspid (5/19, Pablos) reported that a May 17 forum in Sacramento, organized by the journal Health Affairs, brought together “oral health experts and key policymakers” to discuss the state of oral health in California. Dr. Marko Vujicic, chief economist and vice president at the ADA’s Health Policy Institute, was among the forum participants. “The No. 1 reason people report that they don’t access dental care is cost. This is true in every state we’ve studied. It’s true in California ... It’s true among low-income, middle-income, and high-income adults,” Dr. Vujicic said. “This suggests to me that something isn’t working in the dental insurance model.”

9/6/2016 The 12 States with the Largest Dentist Shortages. Faulty information provided by federal officials

08/24/2016 Over-saturation of Dentists, Hygienists a Mounting Problem in Many Markets - See more at more from Dr Christensen

Part of the problem, Christensen says, stems from a proliferation of new dental schools. Of the 12 new dental schools that have started since 1997, eight of them are private. And the frustration among dentists is that many of these schools have established themselves in regions that don’t need new dentists. “I tried for literally 40 years to help start a dental school at the University of Utah, which has since been initiated,” Christensen says. “However, previous to that, a private school came in, and now they’re turning out far more dentists than Utah will ever use. We hope that many will go to areas in which they are needed.”

ADA News Viewpoint April 18, 2016 by Marvin Grossman, D.D.S. Port Washington, New York "I read with great interest the article "Health Policy Institute: Dentists' Earnings Remaining Stagnant" in the Jan. 18 issue of the ADA News. How astounding! Let us dissect and analyze the uncomfortable reasons for this. I thank Marko Vujicic, Ph.D., for his honesty. If the schools keep producing and flooding the market with new dentists, even the blind can see that incomes will not rise. Supply and demand, remember?"

TNN | May 18, 2016, Dentist surplus forces freeze on new colleges in India. Can the same happen in US?

UW Dental School Amasses $29 Million Deficit.

The Seattle Times (4/14, Long) reported that the University of Washington’s School of Dentistry has amassed a $29 million deficit, “unable to earn as much as it thought from its patients — who largely rely on Medicaid — after the school took on debt to renovate a building on the grounds of Magnuson Park.” According to the article, last week the UW Board of Regents reviewed a plan to eliminate the deficit by “seeking larger reimbursements for dental services, cutting $3.5 million in expenses, reducing the size of the staff through attrition, reorganizing the department and optimizing space.” Interim Provost Jerry Baldasty will review the plan, which is expected to be adopted.

10/16/15 ARTICLE by Gordon J. Christensen, DDS, MSD, Ph.D.

Director, Practical Clinical Courses,

Cofounder and CEO, CR Foundation

OVERPRODUCTION OF DENTISTS AND DENTAL HYGIENISTS

I seldom speak in a U.S. dental community where the dentists claim they do not have an adequate quantity of dentists or dental hygienists. Yet we see a continuing movement by some groups to produce not only more dentists, but to initiate the concept of so-called midlevel practitioners. Additionally, many new dental schools have been started in recent years, and more are in the planning stages. Some of these new schools are producing dentists in geographic areas that do not need more dentists, thus increasing the problems of already-struggling dentists. What is the result when an overabundance of dentists or dental hygienists is produced in a community? Competition abounds. Referrals to specialists are reduced. Many general dentists accomplish clinical tasks that could be better done by specialists. Advertising increases. Quality of care is sacrificed. Some dentists go bankrupt! Do dentists in saturated areas go to areas of need, which is the goal of some who support overproduction of dentists or development of midlevel practitioners? Any practicing dentist recognizes that this does not happen. Generally, dentists and hygienists stay in the areas in which they want to live. History has proven that point.What should be done?

The American Dental Association has the responsibility to help provide adequate and qualified dental manpower across the U.S. However, it also has the responsibility to its members to help provide a realistic and needed quantity of dentists for specific geographic areas. Although this is an idealistic suggestion, the ADA dental education accrediting council should make strong suggestions to those attempting to start schools in saturated areas to not do so.

Areas of need are a public health challenge. State or national funds should be appropriated to build clinics and hire dentists and dental hygienists for areas of need

Another suggestion is to require at least one year of service for all new graduate dentists and hygienists in state or federal clinics in areas of need. After personal long deliberation and frustration on this topic, I do not see any other solutions.

10/08/15 From DentalTown: comments from a dentist with a very heavy Medicaid practice " I agree 100% with you john but the problem is I have very...... few FFS pts .How will I survive and pay my fixed costs? I really want to drop Medicaid 1st but the problem is there are many pts who do treatments like implants and crown and pay full fee. Yes they are not many but they are there. What could be a road map? Step by step. Has anyone done that in the past.? How will I afford heavy marketing cost immediately and so forth.."

ACA Has Not Helped Pediatric Dental Care.In a piece for The Hill (8/12) “Congress Blog,” Brendan Williams, a Washington state attorney and former state representative, writes that it “is hard, looking at the data, to remember pediatric dental coverage is actually one of only ten health benefits defined as ‘essential’ under the ACA.” He notes that stand-alone dental plans are the only option in most states, “and just 26.1 percent of eligible children got coverage.” He adds that while dental coverage “was required as part of the pre-ACA State Children’s Health Insurance Program, expanding Medicaid coverage under the ACA to children of the working poor has not changed the fact that Medicaid rates are generally deplorable.” Stating that many liberal states, such as Washington, “are among the very worst Medicaid dental payers,” Williams adds that the ADA’s Health Policy Institute said in an October 2014 report that Washington’s rates had decreased dramatically over a decade.

Access to Care: The Role of the State Dental Board in Public Access to Oral Health Care (Approved by the General Assembly of the American Association of Dental Boards at the Mid-Year Meeting, 3/21/2005) "Care must be exercised in interpreting Dental Health Professions Shortage Areas data. The designation, as currently defined, relates more appropriately to geographic areas where unmet dental needs exist than to the number of dentists located in those areas. Unmet dental needs often are the result of factors other than the size of the dental workforce. Perceived workforce shortages may be the result of the decreased demand for dental services and therefore not to the cause of the unmet dental needs. "

Coverage Continues: Texas A&M University Baylor College Of Dentistry Receives $5.4M In Funding.Dentistry IQ (7/27) reports in continuing coverage that the Health Resources and Services Administration of the US Department of Health and Human Services has provided Texas A&M University Baylor College of Dentistry with $5.4 million in funding “to expand its pre-doctoral and postdoctoral training, helping to bridge the gap that currently exists between medicine and dentistry.” Many areas of the US do not need more dentists most cities are saturated with dentist many of whom are doing unnecessary treatment if you want to see examples look at this site Inferior Dental Care

May 2015 Rethinking dentist shortages ADA-HPI "The modeling of dentist supply, overall, is sound and empirically grounded. HRSA’s model predicts a rising supply of dentists. The American Dental Association Health Policy Institute recently developed a sophisticated empirical model to predict the future supply of dentists, and the analysis also predicts a rising supply of dentists.3 Although there is no way to make an apples-to-apples comparison between the two models, both give the same big picture conclusion: there will be more dentists in the market in the coming years.The best available data show that although dental care use has increased among children, dental care use among adults has declined steadily for more than a decade. The decline in dental care use among adults has caused a significant slowdown in dental spending, a significant increase in the level of unused capacity in the dental care system, and stagnating dentist earnings.

Cigna Earnings Up On Increased Customer Base, Higher Prices.

The Hartford (CT) Courant (5/1) reports that health benefits provider Cigna “reported strong revenue growth” in the first quarter “driven by a larger customer base and higher prices.” The Hartford Courant reports that Cigna’s dental benefits membership increased from 13.3 million to 13.7 million people over the last year. Net income for the quarter was up by $5 million over the year-prior period to $533 million. Why increased numbers of dentists becoming PPO providers that which reduces CIGNA cost

04/16/15 Survey: Nearly Two In Five American Adults Have Limited Dental Care Due To Financial Constraints.

Dentistry IQ (4/16) reports that a survey of more than 1,000 adults by ORC International found that “nearly two in five American adults (39%) say they have limited or plan to limit dental care due to their financial situation, a number that has increased by nearly 8% during the last two years.” Still, 80 percent of respondents “recognize that postponing or delaying routine visits will cost them more money in the long run.” Additionally, 53 percent of respondents “consider routine dental visits for exams and cleanings something that is ‘nice to have’ that can be delayed.”

04/10/15 Survey Finds Many Americans Delay Dental Care Due To Cost Concerns.

Dr Bicuspid (4/10) reports on a survey of over 1,000 US adults finding that “39% of the respondents have limited or will delay dental care because of their financial situation.” At the same time, 80 percent of those surveyed “know that delaying routine visits will cost them more money in the long run.” The survey also found that 53 percent said that “routine dental visits for exams and cleanings” are “nice to have” but may be delayed, and 17 percent said that they “would fix problems with their car ahead of addressing pain in their mouth.”

03/24/2015 Northwest Florida Dental School To Open In Fall 2015.

The Northwest Florida Daily News (3/24) reports that this fall 50 dental students will begin a 48-week primary care clinic at the Lake Erie College of Osteopathic Medicine’s new School of Dental Medicine in DeFuniak Springs, Florida. The school’s clinic will include 30 dental treatment rooms, and is expected to treat 150 patients per day, under the supervision of licensed dental faculty. The article adds that “each year, a new class of dental students will move to the area to complete their final year of clinical training.” "Did anybody survey the dental practices in FL to see if they were working at maximum capacity. Of course not . Just saturate the market with dentists who can not pay back there students loans and put the Federal government deeper in debt. DKMacLeod"

03/20/2015- Dr Bicuspid (3/20) reports that the Academy of General Dentistry president W. Carter Brown, DMD, commended HRSA for “its through and thoughtful research on the future of the dental workforce,” but “said the report overlooks market forces” that influence supply and demand. Brown said, “there is plenty of appointment time available with the dentists and their teams. Factors such as the lack of the patient’s perceived value for dental care and oral health literacy, transportation, and, frankly, fear of treatment are some of the biggest drivers of under utilization of care.” Dr Bicuspid adds that the ADA Health Policy Institute also issued a response to the HRSA report, which “pointed to evidence of flawed demand modeling and unused dental supply capacity as reasons why future supply may be adequate.”

03/19/2015 In this month’s Health Policy Perspectives column in The Journal of the American Dental Association, household spending patterns are examined for a wide variety of items, including vacations, cable television, cell phones and dental care. The data show clearly that household spending on dental care is not rebounding with the economic recovery, while spending on most household items is. In fact, only three items still have declining household spending: legal services, coffee and tea, and dental care. Only have 90 seconds? Watch the video here.

03/09/2015 Dental Caries and Sealant Prevalence in Children and Adolescents in the United States, 2011–2012

03/09/2015 Organization leaders focus on moving forward from CDC caries report

03/01/2015 Below is a comment from a Dentist in Wake County survey I sent in April 2014

"While there is a need and demand for dental services, many of my patients in the last 5 years have elected to have some level of compromised, or less than optimal, dental treatment, due to the generally poor economy. I would always welcome any new dental practice, and would try to support them, as I will always be grateful for those who have stepped forward to help me. That being said, having a significant increase in the number of practices in the area is absolutely no guarantee of patients getting better and less costly dentistry; rather, it decreases the chances for dentists to develop economies of scale (i.e. efficiencies) in their practices, and encourages cost-cutting measures without necessarily also giving better care."

02/25/2015 from ADA Huddle 02/25/2015

Kansas Dental Association, Dentists Oppose Proposed Dental Practitioner Legislation.

The Topeka (KS) Capital-Journal (2/24, Shorman) reported that on Monday “supporters and opponents of registered dental practitioners jousted for legislative approval” in front of Kansas state legislators. The experiences of Minnesota, which allows registered dental practitioners to practice in the state, “proved a focal point in the debate,” however, Kansas Dental Association executive director Kevin Robertson opposed any legislation allowing dental practitioners. Robertson refuted the idea that there is a shortage of dentists in the state, and “said the number of dentists...has grown by 115 since 2009, or an 8.2-percent increase, while the state’s population only has grown 2.5 percent during that time.” Another Kansas dentist argued that allowing dental practitioners would not reduce the cost of care, because patients would have to pay the same fees for the same services, regardless of the provider.

Commentary of above by DKMacLeod: If the Kansas Dental Association had surveyed all dentist in Kansas to see how much open and unused appointments each dentist had they would be able to prove to the legislators that mid-level providers are not needed. If every dentist in Kansas were to adopt and treat one needy family at 50 % reduced fee it would eliminate the argument that the needy can not get treatment.

01/23/2014

The US News “100 Best Jobs” List is Wrong Posted on 20 Jan 2015 by Dr. Chris Salierno Melville, NY

"Right now dentistry is suffering from an increasing supply of dentists and a decreasing demand for our services. Reports like this miss that point and, if anything, contribute to the problem."