This highly charged session distinguished itself on two fronts. It marked the first use of this format in an ADEA Presidential Symposium, and although no one took a precise headcount, it appeared to draw a larger crowd than any other session—plenaries included—with in the neighborhood of 1,000 members in attendance.
The moderator was Peter A. Dubois, Executive Director of the California Dental Association.
The panel members were Dominick DePaola, Nova Southeastern University, David A. Nash, University of Kentucky, Jerold S. Goldberg, Case Western Reserve University, R. Bruce Donoff, Harvard School of Dental Medicine, Richard N. Buchanan, University of Southern Nevada, and Jack Dillenberg, Arizona School of Dentistry and Oral Health.
Dr. Dominick P. DePaola of Nova Southeastern University presented the case in favor of the motion, and Dr. David A. Nash of the University of Kentucky countered. Four panelists responded to their arguments, and then members of the audience eagerly added their voices to the discussion. The debate touched on the faculty shortage, academic research, the cost of education, and the quality of care and of teaching, but time and again it returned to the pressing question of access.
Dr. DePaola’s argument rested on these numbers:
- 4,622 = the number of current Dental Health Professional Shortage Areas (DHSPAs)
- 9,900 = the number of dentists needed to eliminate these DHSPAs
- 50% = the growth in the US population from 2000 to 2050
- 40 million = the projected number of newly insured when the Affordable Care Act is implemented
- 2,000 = the number of dentists that 20 new schools could produce annually with 100 students/class
In short, the demand for care is increasing. “Where is the workforce to care for these people?” he asked.
Dr. Nash disagreed with the assertion that concerns about access provide a rationale for starting new schools and offered a few numbers of his own.
- 1982 = the peak year for dental graduates and a time when access to care was also inadequate
- 483 = the number of new slots that established dental schools have added in recent years
- 55% = the increase in the number of international students in the last decade
- $250-300,000 = the likely indebtedness of a graduate of one of the new dental schools
- 8-11 v. 2-3 = the number of years of university training for a dentist v. the number of years of training for a dental therapist
A self-described vocal advocate for dental therapists, Dr. Nash concluded that most children need dental exams, prophylaxis, sealants, and topical fluoride, procedures that can be more efficiently offered by non-dentist providers.
The presenters, the respondents, and members of the audience fleshed out these arguments and paid serious attention to the roles that academic research and new approaches to teaching have in shaping the competencies of graduates and the quality of care they provide. Despite stark disagreements on many fronts, everyone seemed to agree with Dr. Jack Dillenberg’s passionate assertion, “We gotta change!” if we want to increase the percentage of dentists working in community health settings. Currently it stands at 1%. One other point of consensus: that change won’t happen unless we all work together.