A decline in dentists

CEDAR RAPIDS — In a lot of ways Dr. Katie Milden, a Cedar Rapids dentist, represents the changing face of Iowa's dental workforce.

The 2010 graduate from the University of Iowa College of Dentistry and Dental Clinics bought her own practice in 2014. She's now working to grow her business, both in clients and eventually adding more dentists.

Her father, Gary Milden, also is a dentist in Cedar Rapids, and Milden said it was important to her to establish a practice outside her family.

Iowa's dental work force looks very different from it did 18 years ago — with far more women practicing and the average age of working dentists steadily climbing. That's according to new data in several issue briefs out by the University of Iowa's Public Policy Center.

The briefs laid out dentist-workforce supply trends in Iowa from 1997 to 2013 to help the UI's College of Dentistry and Dental Clinics better anticipate potential shortages and focus retention and recruitment efforts.

'We needed baseline information,' said Dr. Raymond Kuthy, a professor in the college of dentistry and co-author of the briefs, which analyzed information from the Iowa Dentist Tracking System — part of the University of Iowa's Office of Statewide Clinical Education Programs.

The number of dentists practicing in Iowa has increased since 1997 but at a far slower rate than the national pace, the briefs found. In Iowa, the number of dentists increased 8 percent from 1997 to 2013, while it rose 21 percent in roughly the same time frame nationally.

What's more, the Health Resources and Services Administration, a federal agency, projects a potential nationwide increase of 11,800 dentists by 2025, or a 6 percent rise. But Iowa projections suggest a 15 percent decrease in the dental workforce.

Shifting demographics

'We see baby boomers retiring,' said Dr. Julie Reynolds, another author of the briefs. 'The number of older dentists has doubled.'

The average age of Iowa dentists is rising — climbing from 47 to 50 from 1997 to 2012 — and the proportion of Iowa dentists aged 55 and older has almost doubled — jumping from 23 percent to 42 percent in that time period.

Meanwhile the proportion of dentists aged 35 to 54 has decreased by 26 percent — falling from 62 percent in 1997 to 36 percent in 2013.

This is not unique to Iowa, Reynolds said, as the proportion of U.S. dentists aged 55 or older grew from 24 percent to 42 percent from 1997 to 2011, and those aged 35 to 54 dropped from 61 percent to 45 percent.

Another major shift — the number of practicing dentists who are women in Iowa has more than doubled over the 18 year time period, with women making up a quarter of active Iowa dentists in 2013. There's also been an increase in the percentage of women graduating from the UI's College of Dentistry and Dental Clinics, hitting 41 percent in the 2012-2013 school year.

The briefs point out that the growing number of female dentists could affect the state's workforce capacity as studies have shown women tend to work fewer hours than men and are less likely to practice in rural areas.

Rural dentists

Compounding this problem is the fact that fewer dentists are choosing to work in rural areas overall, 36 percent in 2013 compared with 49 percent in 1997.

More than one-third of private practice dentists were working in Polk, Linn and Scott counties while two-thirds of Iowa counties are considered dental health professional shortage areas — a federal designation given to areas that have an acute shortage of primary health care professionals.

Older dentists nationwide are more likely to practice in rural areas than younger dentists, a trend seen here in Iowa, according to the briefs. In 2013, 41 percent of dentists aged 55 and older practiced in a rural county compared with 31 percent of younger dentists.

Six of the nine general dentists in Keokuk County — population 10,500 — are over the age of 60 and seeking to retire, for example, said Deb Hoyle, coordinator of the Office of Iowa Practice Opportunities, part of the college of dentistry. Hoyle discussed the situation with Keokuk officials, including members from the area chamber of commerce and hospital.

The office, which was created in 2006, has helped place 186 graduates in jobs across Iowa.

'We're really a facilitator between those with opportunities and those needing opportunities,' she said.

The college has built up its recruiting efforts over the years, creating a new website, hosting an annual conference and providing loan repayment, briefs co-author Kuthy said.

He plans to share this information with interested parties, such as Delta Dental of Iowa Foundation, economic development groups, Iowa Dental Association and the Iowa Department of Public Health. It also will release three more briefs relating to the dental workforce.

That way, the groups can plan and work with communities.

'It's easier to access ...

care, so residents don't have to drive miles and miles,' Hoyle said. 'But dentists are also important for business reasons. If you're recruiting companies to the area, one thing the business will look at is what the health care situation is like.'