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OPINION

Column: Dentists focused on access to care

Dr. Mark Johnston

Re: The op-ed in the Feb. 27 Detroit News: “Shortage of dentists makes case for change”: James Haveman stated that a shortage of dentists contributes to the access to care problem in Michigan.

But in order to improve access to oral health for all Michigan residents, it’s critical to examine the right issues. From what we see and experience daily, the real problem is a maldistribution of dental providers. We must focus on the real and root cause of the access to dental care problem to solve it.

According to a report by the Center for Health Workforce Studies, School of Public Health at the State University of New York — Albany (the source of Haveman’s data), “Michigan appears to have a reasonable supply of dentists and dental hygienists when benchmarked to national dentist-to-population ratios.” Indeed, in Michigan there are currently 7,500 licensed dentists, more than 10,300 licensed hygienists, and 1,750 licensed dental assistants. Dentists have capacity in their offices to take on new patients and too many hygienists are unemployed or underemployed.

Additionally, the number of graduating dentists is outpacing the number of retiring dentists. So, there is no shortage of dental care providers. The key is to get dental providers into Michigan communities that are underserved.

One out-of-state organization has decided that a mid-level provider is the answer to the access problem in Michigan. However, this proposed solution requires years of training for a new provider and in the few states where the model exists the results are unproven.

The Michigan Dental Association (MDA) has been working to advance solutions to the access to care problem for years and while there have been notable successes like the Healthy Kids Dental program; we all know that more needs to be done.

That is why the MDA is working with state legislators to propose a common sense solution that can have an immediate impact and takes advantage of Michigan’s current talented workforce. This solution involves allowing individual dentists to take part in an existing state program that is currently far too underutilized.

The proposal would allow a hygienist to treat underserved patients, in non-traditional settings, who have not first been examined by a dentist. If the patient is determined to need follow up care he or she is referred to the dentist who collaborated with the hygienist. This proposal will create an economically sustainable model of care that will help spur an underutilized workforce to provide this essential care in underserved areas.

Connecting more people to dental care is a complex problem that not only involves addressing workforce issues, but also includes improving understanding of the importance of oral health, properly funding public health programs, addressing both transportation and cultural/language barriers, and alleviating people’s fear of the dentist. The answer is not to create a new provider system in Michigan when the state already has the dental providers it needs, but to use our existing, well-trained and experienced providers more effectively and efficiently.

Dr. Mark Johnston is the Michigan Dental Association’s 2015-16 president and has been a dentist in mid-Michigan for the last 20-plus years.