Author, Gabriel Carraro de Andrade is a recent graduate and research intern at the DeVoe L. Moore Center in the College of Social Sciences and Public Policy at Florida State University where he majored in economics.
The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, indicates that Florida is the worst state in the nation for dental access.
Currently, 65 of Florida’s 67 counties are designated, either in full or in part, as dental health professional shortage areas, with population-to-dentist ratios exceeding 5,000 to 1.
This has left over 7.1 million Floridians living in “dental deserts.”
According to HRSA, an additional 1,536 dentists are needed just to eliminate the current shortages. Lafayette County in the Big Bend has no dentists at all, and there are several other counties where the ratio is as low as one-tenth of the national average. This is a critical issue, as dental health is as important as general health care.
A Florida Workforce Survey regarding dental care professionals found that around 70% of dentists work in a general private practice, while only 4% work in a public health practice. The lack of dentists in public health limits accessibility to dental care. Many private practices do not accept Medicaid.
With an aging population and declining interest in healthcare professions among younger generations, the dental care shortage is worsening. The same Workforce survey found that a mere 4.7% of dentists are 20-29 years old, and the extensive process of becoming licensed as a dentist in the United States is scaring university students away.
On average, students require six to eight years before they are able to practice in Florida, excluding any specialization licenses.
Increases in costs of living due to post-COVID inflation have caused many to avoid taking out massive loans needed to afford dental school, since these costs can range from $100,000 to a whopping $400,000.
Florida needs more accessible licensing pathways. According to the American Dental Association (ADA), a dental hygienist is responsible for performing preventive care, such as teeth cleanings, oral health assessments, and providing guidance on maintaining oral hygiene, which supports the work of dentists but does not involve advanced or invasive procedures. Additionally, a dental hygienist needs a license to apply anesthesia, strangling even more the supply of professionals.
However, the current licensure process requires candidates to have graduated from an ADA-accredited dental hygiene program or an unaccredited dental program with equivalent training. Additionally, a dental hygienist needs a license to apply anesthesia, which they rarely if ever apply directly, limiting even more the supply of professionals.
Applicants must pass multiple examinations, including the National Board Dental Hygiene Examination, ADEX Dental Hygiene Licensing Examination, and Florida Laws and Rules Examination. They are also required to submit numerous documents, such as official transcripts, certification of licensure, and even proof of CPR and AED training.
The licensing problem is even more bizarre for immigrants wth foreign licenses as their license is worthless regardless of their experience and practice as a dentist. Foreign dentists must start their studies from zero and enroll in dental school.
Moreover, Florida public dental schools, such as the University of Florida (UF) require applicants to be permanent residents. Excessive lawyer fees and a lengthy process mean foreign dentists must wait at least seven years to be able to apply to dental school. Affordability and complexity push away skilled workers looking to serve the American population.
Florida is facing a dental care crisis, and reducing unnecessary barriers for individuals entering dentistry, particularly for immigrants with foreign dental training, would help address this shortage.
Loosening these restrictions to allow competent and talented dentists and hygienists into the field would reduce wait times for patients and ensure that preventive dental care is accessible to more communities in need.
A change of this magnitude would serve as an example for reform in other fields in need, such as general health care and even education. The overarching issue of the labor shortage and gap is not being given the required attention from politicians, and even those running for the highest ranks in the US.