August 7, 2019
As of 2018, the Bureau of Health Workforce had identified nearly 6,000 areas in the US with inadequate professional dental care. Around 54 million people live in those shortage areas, and it is estimated that nearly 10,000 additional practitioners are necessary to meet their needs. This paper explores the academic literature on occupational licensing to understand whether licensing laws are contributing to this shortage and if reforming those laws could increase access to dental care.
Occupational licensing limits access to dental care
Licensing laws are intended to safeguard consumers from being harmed by ill-qualified or undertrained practitioners. In the field of dentistry, this means that in addition to requiring dentists to have a license, states also place a number of restrictions on mid-level practitioners like dental hygienists. Mid-level practitioners are qualified to perform preventative dental procedures like cleanings and sealants, but licensing laws limit their ability to perform these services. As a result, the number of services that can be provided outside of dental offices shrinks, raising the price of dental care. Of US adults who did not visit the dentist in the past year, over half pointed to high fees as their reason for not seeking care.
Licensing also reduces the number of dental service providers available to consumers because it acts as a barrier to employment. Further, state-specific licensing makes it harder for dentists to relocate to states with higher demand for dental services, as different states have different requirements for licensure.
Empowering dental assistants can improve access to dental care
- Because they require less training than dentists, mid-level providers offer less complicated services at lower costs.
- If restrictions on mid-level providers are reduced, the number of providers performing those services would likely increase, expanding access to dental care.
Occupational licensing reforms in other industries have lowered costs, improved opportunities for workers, and increased consumer access to services. Changes in the dental field could have similar results. In light of this, policymakers should focus on pursuing reforms to current occupational licensing laws, such as expanding autonomy for mid-level providers.
CGO Undergraduate Research Fellow