Over-saturation of Dentists, Hygienists a Mounting Problem in Many Markets


In many markets, there are more dentists and dental hygienists than the market requires. The problem, one expert says, is partly due to a growth of dental schools in markets that are already over-served.

The American Dental Hygienists’ Association indicates that approximately 6,700 dental hygienists graduate annually. Add that number to the more than 5,000 new dentists coming into the fold each year and you have a lot of people to fill not nearly as many jobs.

In other words, with apologies to Abbott and Costello, 7 will not go into 28, 13 times. That’s problematic math. It’s also a major problem for the dental industry.

Gordon Christensen, DDS, MSD, PhD, founder and CEO of Practical Clinical Courses, explains.

“You have somewhere around 5,000-plus new dentists graduating, and somewhat over 50 percent of dentists employ hygienists,” said Christensen. “…If you tried to put 6,000 hygienists into 5,000 dentists, many of whom don’t have a hygienist, you see where you are.”

It’s called oversaturation, and it’s a major frustration to dentists who see it happening in their respective geographic communities.

New Schools

Part of the problem, Christensen says, stems from a proliferation of new dental schools. Of the 12 new dental schools that have started since 1997, eight of them are private. And the frustration among dentists is that many of these schools have established themselves in regions that don’t need new dentists.

“I tried for literally 40 years to help start a dental school at the University of Utah, which has since been initiated,” Christensen says. “However, previous to that, a private school came in, and now they’re turning out far more dentists than Utah will ever use. We hope that many will go to areas in which they are needed.”

When these private schools began to surface in the late 1990s there was great resentment because it appeared they were primarily oriented toward making money for the people who initiated them. But Christensen acknowledges that some of them are educating dentists in a very admirable manner.

“They’re recruiting faculty who are general practitioners or specialists from their local communities rather than going after pure blood academics,” he explains. “Therefore, many of them are getting better clinical education because it’s real world rather than just academically oriented.”

Christensen says that if he were “a grand mogul” running the dental industry he would stipulate for those who wanted to start a dental school that they were limited to four or five areas of need where they could break ground.

“But don’t go into an area where dentists are treating one another for lack of something to do,” he says. “And that’s happening in many areas.”

Hygienist Impact

Dentists aren’t the only ones feeling the effects of oversaturated markets. Dental hygienists are hurting as well. Christensen recalls that hygienists used to be able to practically set their own salary, and that’s still true in selected areas.

“One of my sons practices in a rural area in Ontario, Canada, and he can’t even get hygienists,” he says. “They have to pay them an enormous fee, and they have to stimulate them to move away from a metropolitan area into a rural area.”

But most markets, he says, are so oversaturated hygienists cannot find employment. That’s an incredible shift from just three years ago, when the CareerCast website ranked dental hygienist number six as best jobs of 2013. The site indicated, “Opportunities in the field are abundant and expected to grow considerably by 2020.”

Clearly, that isn’t the case.

What to do?

Christensen says “it’s near impossible” for a young dentist coming out of school to start a practice on their own.

“They can do it,” he says, “but they’d better plan to garden and get a cow to give them some milk because they’re not going to eat anything for quite a few years.”

As a result, a sizeable number of new dentists are going into the military as dentists.

“That’s a wonderful thing,” Christensen says, “because they get experience they would never get in dental school.”

Many others are turning to corporate dentistry, despite the lower starting salary. For example, the American Dental Association reports that in 2013, the average annual net income for general practitioner dentists was just under $181,000. By comparison, Christensen says a typical corporate dentist earns approximately $130,000.

“It’s a sizeable chunk lower, but it’s a place where a young dentist can go and gain some skills, and gain some speed,” Christensen says.

So what advice does Christensen have for young dentists who want to start a private practice?

“They have to do something different,” he says. “They must have internal and external marketing. They’ve got to identify themselves as different from some other dentist down the street. Write a column or article in your hometown newspaper and stimulate people to come in. So, there are ways, but they’re proactive ways, they’re certainly not reactive ways. They’ll go bankrupt if they don’t do something different.”

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