Dr. Darleen Oleski operates two dental practices, one in Scranton and one in Tunkhannock. She now works with her daughter, who is just two years out of dental school.
“My dear friend could not find anyone to buy his practice in Tunkhannock. For five years, he was ready to shut the doors. And my daughter, who graduated from University of Pittsburgh two years ago, said, ‘Well, why don't we try to buy that?’ She couldn't possibly buy that. She had $380,000 in debt. So mom bought that,” Oleski said.
They split their time between the Scranton and Tunkhannock offices.
The issue facing Oleski’s retired colleague has proven to be one impacting dentists statewide. The Center for Rural Pennsylvania found that more than 20% of dentists in the state are older than 65. An additional 20-plus percent are nearing retirement age. Many are not being replaced once they retire.
State Sen. Dave Argall (R-Schuylkill County) chairs the Senate Majority Policy Committee. He convened a public hearing Monday at Benco Dental in Jenkins Twp. to learn more about the aging dental workforce and other factors contributing to the state’s shortage of dental professionals.
Challenges contributing to Pa.'s dental workforce shortage
Oleski said working with dental insurance companies can create a hostile work environment. Pennsylvania has low reimbursement rates from all types of insurances for dental services, the panel heard.
“We're 47th in reimbursement in the country, in Pennsylvania, so 46 other states reimburse more for the same procedure than we do in Pennsylvania,” said James Mancini, president-elect of the Pennsylvania Dental Association.
Because of that, Pennsylvania experienced the highest decline in the number of dentists per 100,000 residents in the whole country, according to the American Dental Association. That's about a 13.3% decline in the supply of dentists.
“So a lot of dentists feel that the work environment in Pennsylvania, in terms of working with insurance companies, is very difficult. Other states near us — Delaware and New York, in New Jersey — [are] much more favorable places to work and [have] less issues regarding the day-to-day,” Oleski said.
Shawn Casey operates Casey Dental in Pittston. He said high debt turns young people away from dentistry.
“The average debt of a dental student is probably about $450,000. The average income when a dentist comes up, not a specialist, is probably about $150,000 to $210,000. So how do you get that ring, how do you get that [return on investment] back when you want to start a family, buy a car and pay rent? Doesn't work,” Casey said.
Dentists also experience burnout due to the shortage of dental hygienists.
“Pennsylvania has a severe and worsening shortage of dental hygienists. That's our biggest problem," said Michael Verber, CEO of Verber Dental Group, located in Cumberland County.
"If you look at our population, we need four times the number of hygienists we currently have to serve our population in any sort of preventative fashion. Pennsylvania currently operates at a one-to-one hygienist to dentist ratio," Verber said. "The Pennsylvania Coalition for Oral Health suggests a two-to-one ratio.”
He said the state does not have enough dental hygiene programs, and that the existing ones accept less than 10% of qualified applicants.
Potential solutions to Pa.'s dental workforce shortage
Casey suggested expanding work capabilities of expanded functions dental assistants, or EFDAs.
“They can give chair-side local anesthetic, help speed up the day for a doctor, take the burden off their stress on a daily basis. They can access and they can see more patients, and I think give them more credibility. They’re a very valuable asset,” he said.
Ann Hoffman, the dental program director at Central Penn College, suggested expanding dental hygiene programs throughout the state. Many programs need financial assistance for upfront costs for equipment and technology.
“In Pennsylvania, there's approximately 13 dental hygiene programs unevenly distributed and with clear gaps in the rural areas. At the same time, we're facing a projected 30 to 40% reduction in dental hygiene workforce by 2040,” Hoffman said.
Temple Dental’s Kornberg School of Dentistry will open its Tamaqua campus and welcome its inaugural rural dentistry cohort this fall semester. Argall at first feared a lack of interest in the program. But he left a recent visit pleasantly surprised at the enthusiasm from students.
“When we first announced this new program, we said, ‘Well, are we going to have to wine and dine these students to get them to come to a small town.’ And no, no, we are over subscribed,” Argall said.
The clinic will host 10 third-year dental students and 10 fourth-year dental students each year.
Students will serve patients from Schuylkill, Carbon and Luzerne counties at the clinic, which will be located at the site of a former Rite Aid in downtown Tamaqua.
