Oral care is getting hard to find in the Hawkeye State. The University of Iowa (UI) Public Policy Center says that almost half of the state’s dentists are nearing retirement age, fewer dentists are practicing in rural areas, and the proportion of dentists who work in solo practice is declining.
“Having a sense of what is going on statewide allows us to be more proactive in our recruitment and retention efforts,” said Julie Reynolds, a visiting assistant dental professor at the UI College of Dentistry & Dental Clinics and co-author of the study, which analyzed state workforce data collected by the Iowa Dentist Tracking System during a 17-year period.
“No one wants to have to drive 2 hours to see the dentist, so collecting this data can help the College of Dentistry continue to partner with communities, proactively plan, and encourage talented students to practice in Iowa after graduation,” Reynolds said.
The proportion of Iowa dentists who are 55 and older nearly doubled from 23% to 42% between 1997 and 2013. Also, the proportion of dentists in rural areas has decreased from 49% to 36%. Plus, a third of Iowa’s private practitioners are concentrated in Polk, Linn, and Scott counties, which account for only 27% of the state’s population.
“These changing demographics are likely to impact overall practice patterns, as well as the geographic distribution of Iowa’s dentists,” said Raymond Kuthy, UI professor of preventive and community dentistry.
As younger dentists enter the workforce, Kuthy noted, there may be a shift toward group or corporate practices. For example, the number of dentists in solo practice declined from 59% in 1997 to 43% in 2013.
“People who go into group practice tend to wind up in larger communities because it provides them with a larger patient pool, better emergency coverage in the dentist’s absence, and the ability to vary their work hours,” said Kuthy, who added that this shift could threaten access to care in rural communities.
Working with the UI College of Dentistry and Dental Clinics, the state Office of Iowa Practice Opportunities (OIPO) has helped facilitate 188 placements, including 88 in rural communities, throughout the past 10 years. Its website includes an interactive map showing current opportunities in Iowa’s 99 counties. About 75% of Iowa’s dentists are UI College of Dentistry graduates.
To address the shortage, the University of Iowa Public Policy Center is executing a 4-point plan:
- It will develop activities with the OIPO that foster collaboration with stakeholders to recruit dentists to areas facing shortages.
- It will coordinate and expand the Iowa State Loan Repayment Program for dental providers and facilitate other recruitment and retention programs.
- It will conduct workforce monitoring of dental providers, including longitudinal trends and geographic relationships with other primary care providers.
- It will define dental service areas based on patient utilization patterns to identify geographic barriers to care for vulnerable populations
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