June 20, 2007

Results from surveys of licensed Michigan dentists and dental hygienists, conducted by the Michigan Department of Community Health (MDCH), show high rates of workforce attrition in the next ten years, lack of diversity in the oral health field, and limited oral health care options for Medicaid patients and the uninsured.

The 2006 Survey of Dentists and 2006 Survey of Dental Hygienists reports include information on employment status, age, plans to continue practicing, work setting, education, gender, and racial/ethnic background of licensed dentists and hygienists in Michigan.

Key findings from the surveys indicate the following:

• 43 percent of dentists and 38 percent of hygienists plan to practice for only one to ten more years. These rates are high compared to both registered nurses and physicians, of whom 33 percent and 34 percent, respectively, plan to practice for only one to ten more years.
• Seven percent of dentists plan to retire, seven percent plan to reduce patient care hours, and two percent plan to move their practice out of state in the next three years.
• 37 percent of dentists are aged 55 or older, and 80 percent of those who plan to retire or reduce patient care hours cite age as a factor in their decision.
• 14 percent of dentists and 8 percent of hygienists are working in their respective fields outside of Michigan.
• 81 percent of dentists are male, and more than 99 percent of dental hygienists are female. 85 percent of dentists and 95 percent of hygienists are white.

"The survey findings certainly suggest that we will need to continue to expand the oral health workforce to meet the needs that are created by turnover in the field as well as by a lack of diversity," said Janet Olszewski, MDCH Director. "The fields of dentistry represent a growth industry, according to the Bureau of Labor Statistics, and should be marketed to both young men and women, and especially to minorities."

The survey also found that the vast majority of Medicaid and uninsured dental patients are seen by a small minority of dental providers.

• 64 percent of dentists report that none of their patients in a typical month are children covered by Medicaid or MIChild, and 1 percent of survey respondents report seeing an average of 250 or more of these patients each month. 
• 86 percent report that none of their patients in a typical month are adults covered by Medicaid, and one percent of respondents report seeing an average of 60 or more of these patients each month.
• 75 percent report seeing 20 or fewer uninsured children in a typical month, while one percent of respondents see an average of 300 or more of these patients each month.
• 75 percent also report seeing 30 or fewer uninsured adults each month, while one percent of respondents see an average of 500 or more of these patients each month.

According to Dr. Sheila Semler, oral health director at MDCH, "Dental access remains a serious issue in Michigan. With the slowing economy, reduction in Medicaid reimbursement for dental procedures, and a workforce that is focused on private practice, dental care for the economically disadvantaged and minority populations is almost non-existent."

Drew Eason, executive director of the Michigan Dental Association, says both surveys are useful tools for assessing the supply of the workforce: "These surveys provide us with valuable information about the future plans of dentists and the factors affecting their decisions. Having similar information about hygienists gives us a broader picture of the future of the oral health field in Michigan."

Sandy Franklin, president of the Michigan Dental Hygienist Association, agrees: "Both of these surveys provide important data for us to consider as our association moves forward."

In an effort to better understand and gauge the supply of the health care workforce, the Bureau of Health Professions within MDCH is conducting annual surveys of a variety of licensed health professionals in Michigan. Dentists and hygienists were surveyed for the first time in 2006 and will be surveyed again in the summer of 2007.

Public Sector Consultants Inc., a Lansing-based public policy research firm, conducted the surveys and prepared the reports for the Michigan Healthcare Workforce Center (MHWC). Responses to the detailed dentist and hygienist survey questionnaires were received from 697 dentists and 2,062 licensed hygienists, respectively.

The MHWC is an informational resource initiative designed to gather, review, and disseminate information on issues related to the health care workforce. The MHWC was established in 2005 through a collaborative agreement between the Michigan Department of Community Health, Department of Labor and Economic Growth, Department of Education, and Department of Human Services. The full reports, Survey of Dentists 2006 and Survey of Dental Hygienists 2006, are available online at www.michigan.gov/mhwc under Licensee Surveys.