Virginia Has a Significant Shortage of Dental Hygienists
Lack of space in dental hygiene programs is causing the shortage, and closure of the Moss Free Clinic is affecting Germanna's dental hygiene program.
By Adele Uphaus
MANAGING EDITOR AND CORRESPONDENT
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Right now in Virginia, it’s harder to get into a dental hygienist program than it is to get into the University of Virginia, an elite university with an acceptance rate of 15%.
“It shouldn’t be that way,” said Paul Logan, director of strategic initiatives and innovation with the Virginia Dental Association. “What we have right now is a bottle neck with the education programs.”
This bottleneck has resulted in a shortage of dental hygienists in the state, according to a report presented in June to the Virginia Board of Dentistry—a shortage that will lead to longer wait times for preventative oral health care, the VDA warns.
The Virginia Department of Health Professions’ Healthcare Workforce Data Center found that there are 6,283 dentists licensed to practice in Virginia, compared to 5,306 dental hygienists.
The shortage means there are wait times of 10 months or more in some places to get an appointment for a cleaning, which means people aren’t able to get in the recommended two times per year.
“It’s especially difficult when you have Medicaid patients that are allowed three cleanings per year because of existing health issues, and they can’t get in,” Logan told the Advance in an interview. “So even in the somewhat short term, we’re going to see the negative overall health impacts as a whole in the Commonwealth if we can’t fix this.”
A dental hygienist is the preventative specialist in a dental office—the person who who cleans, polishes, and flosses your teeth before the dentist rolls in, and who alerts the dentist to any issues he or she should take a closer look at.
“You want to be spending more time with your hygienist and not on some restorative procedure,” said Ryan Dunn, VDA’s chief executive officer. “They keep you healthy and identify small issues when they are still small issues.”
Without preventative maintenance, “something that could have been treated quickly becomes a more complicated problem,” Dunn said, because dental health is linked to overall health in many ways.
Cavities, if they aren’t identified quickly, can become infected and the infection can spread to other parts of the body. Conditions such as cardiovascular disease, pneumonia, and pregnancy and birth complications can be caused by poor oral health, and conditions such as diabetes, HIV/AIDS, cancer, and Alzheimer’s can affect oral health.
The shortage, and its effect on access to preventative care, is “really becoming a crisis,” Dunn said.
“Imagine if you showed up at the hospital and there were more doctors than there were nurses,” he said. “It would not be a pleasant experience. That’s what dental clinics are dealing with now.”
Lack of access to training programs
At the root of the shortage is a lack of access to dental hygiene education programs in the state, according to VDA leaders. Virginia needs 1,000 new dental hygienists to fill the gap, Dunn said, but only about 135 are graduating each year.
The largest program, at Northern Virginia Community College, graduates about 30 each year. Germanna Community College graduates five.
“At that rate, being down 1,000 or more, you really are never going to get out of this hole without some drastic re-thinking of the commitment from the state,” Dunn said.
“We have a great community college system, but for too long hygiene has not been invested in at a statewide level,” he said. “Unfortunately, we have programs around the Commonwealth that are shrinking and closing instead of expanding, because truthfully, it is an expensive program.”
The programs are costly in terms of the equipment, space needed for students to learn and get clinical hours, and the faculty required to maintain a small ratio of one instructor to five students, said John Stroffolino, associate dean of health techologies at Germanna Community College.
Staffing these programs is also a challenge, he said, because clinicians generally have to take a pay cut when they go from seeing patients to teaching.
Dental hygiene programs are in high demand because the job pays well and has a high satisfaction rate.
“It’s #1 out of the health professions in terms of annual pay coming out of the community college system,” Dunn said.
Logan said that surveys reveal that the job satisfaction rate is much higher for hygienists than it is for dentists. The recent report given to the state board of dentistry revealed that there are only five voluntarily unemployed hygienists in the state, out of a workforce of 5,000, he said.
But available space can’t accomodate the demand. Logan said there were 70 applications this year for the five available slots in Germanna’s program—and the closure on August 8 of the dental clinic at the Lloyd Moss Free Clinic, where Germanna’s dental hygienist students gained clinical hours while providing free dental care to the low-income population, means the community college is scrambling to find new space.
William Berry, director of marketing and recruitment for Germanna, said the Moss Free Clinic’s closure “is a challenge and real loss for the region.”
“We are actively working to identify new clinical partners to support our dental assisting and hygiene programs and students,” he said. “Additionally, our planned new building at the Locust Grove Campus in Orange, Virginia, will include a clinical facility that will expand access to dental training for students in the western part of our service area.”
Stroffolino said the plan is for the Locust Grove facility to open in two years.
Potential solutions
Stroffolino said the Virginia Community College System is focused on understanding and solving the dental hygienist shortage. VCCS is working with Delta Dental of Virginia Foundation to fund partnerships between community colleges in the state and therefore expand access to dental hygienist and dental assisting programs.
For instance, Germanna has a partnership with Mountain Empire Community College, extending its dental assisting program to students there through interactive video, Strofolino said.
Some other solutions, according to Logan and Dunn, could include partnering with K-12 schools to start students down the path towards dental hygienist certification earlier and rethinking tuition rates for dental hygienist programs.
The VDA is encouraging patients to book any upcoming appointment now to ensure they can get in before the end of the year.
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Spotsy has a great dental assistant program for students and they can go right into an assistant role and then on to hygiene school or dental school.
What about the programs at VCU and ODU? What are their numbers?