It may appear that Michigan has just the right number of licensed dentists and dental hygienists, who perform certain procedures under the direct supervision of a dentist, but not as many as a dental therapist would. There are about 7,700 licensed dentists and more than 10,000 dental hygienists in Michigan. About 87 percent of dentists are licensed in general dentistry and 13 percent specialize in a particular area, such as orthodontics or periodontics. In 2011, there were about 6.2 dentists per 10,000 people in Michigan, exactly the national average. And Michigan has two dental schools and 12 dental hygiene programs.[52]
However, dentists are not evenly distributed around the state, which makes it harder to gain access to a dentist in some areas than others. In 21 counties, there are fewer than 3.5 dentists per 10,000 people, and in another 20 counties there are between 3.6 and 4.9 dentists for 10,000 people. This means that although Michigan’s overall ratio of dentists per 10,000 people is at the national average, people living in about half the counties in this state have far fewer dentists available.[53]
Additionally, Michigan’s current crop of dentists is aging. According to a 2011 survey, 52 percent of dentists in Michigan are 55 years old or older.[54] With the average retirement age for dentists at 69 years old, it’s likely that within the next 10-15 years, roughly half of Michigan’s current dentists — about 3,850 — will retire.[55] In fact, when asked how long they planned to continue practicing, 50 percent of Michigan dentists said they planned to continue practicing for less than 10 years. That was five years ago.[56]
It’s unlikely that the shortages created by these retiring dentists will be filled in a timely manner by the normal flow of new dentists from Michigan dental schools. About 81 percent of current dentists attended one of Michigan’s two dental schools: the University of Michigan School of Dentistry and the University of Detroit Mercy School of Dentistry.[57] These schools combined enroll approximately 150 new students per year.[58] If they graduate a similar number each year, there will not be enough new dentists to replace the ones planning to retire, reducing the supply of dental services.
A dental shortage is important for at least two reasons. As a shortage of dentists rises, so will prices, which will make it even more difficult for low-income families to afford routine dental care. Second, shortages will likely be more prevalent and more severe in the areas in the state that are already underserved. This will exacerbate the problem the state already faces with providing access to affordable dental care in rural areas.
Dental therapists can help ease some of these problems by enabling dentists to maintain their practices during a period when there may not be enough new dentists available to replace the retiring ones. Given this looming dentist shortage in Michigan, these midlevel providers could become an important part of the effort to maintain or quickly replenish the supply of dental care available to Michiganders.