Introduction

The availability of competent, well-trained dental hygienists and registered dental assistants is crucial to ensure the expedient and efficient delivery of quality dental care. As the need and demand for dental services increases, it is imperative that all dental offices be fully staffed. When an office is inappropriately staffed, productivity and efficiency suffer. There are areas of the state where access to care has become a problem for everyone — not just for patients on publicly funded programs. That lack of access is due at least in part to dental workforce shortages of varying degrees in different parts of the state.

This article reports the findings of a survey of Minnesota allied dental education programs conducted by the Minnesota Dental Association’s Dental Education Committee early in 2004. The purpose of the study was to better understand the specific needs and concerns of the programs based on information gathered from each program director. Although information about allied dental education has been collected in the past, too often the needs expressed by the programs did not make it to the eyes and ears of those who may be able to help. (That means you, our dentists!) So this year we are making such information available to a wider audience, thus giving everyone an opportunity to “make a difference” in meeting the programs’ expressed concerns. It is very important that members of the Minnesota Dental Assiociation stay in touch with and support their local dental assisting and dental hygiene programs in a variety of ways.

Survey Method and Materials

There are 15 dental assisting programs and 11 dental hygiene programs (including those at North Dakota State College of Science) educating the majority of Minnesota’s allied dental professionals. A cover letter signed by committee chair Dr. Michael Zakula was mailed with a two-page questionnaire to all of these 26 program directors in February 2004. Dental Education Committee members were assigned specific programs and were asked to contact the program directors either by telephone or in person.

A 15-item questionnaire was used to solicit current information about the following topics from each program:

• recruitment methods,

• admissions criteria and enrollment,

• program needs, and

• percentage of graduates who remain in the area and who move away.

Questionnaires were completed either by the program director or by a committee member as he or she “interviewed” the program director. Completed questionnaires were sent to the MDA office, where final results were compiled by MDA staff.

Results

The survey achieved a 100% response rate, with all 26 allied dental education programs responding. Collectively, the dental hygiene and the dental assisting programs reported being approximately 94% filled to capacity with students. Having these programs operating at such a high capacity is excellent news.

Recruitment. Dental hygiene and dental assisting program directors reported using a variety of student recruitment methods, including the following:

• word of mouth,

• direct mailings to dental offices,

• sending students into the community to do community service,

• high school and college career fairs,

• an “Adopt a High School Student” program,

• Web site information, and

• campus visits to learn about the school and the program.

Some reported that recruitment efforts are done by the school as a whole rather than directly by their own programs. Most programs reported having relatively little funding specifically earmarked for recruitment purposes. However, some noted that their most successful recruitment methods were the less costly methods like personal contacts and word of mouth.

Admissions: Dental Assisting.   Several dental assisting programs have open enrollment, allowing admittance on a first come, first served basis for applicants who possess a high school diploma or a GED. Some reported testing basic reading, writing, and math skills. One requires a dental office visit so the applicant understands the typical work environment of a dental assistant. One program noted that most of their applicants already have completed one year of college, and another program indicated intending to add prerequisities such as being current in CPR and having taken a communications course.

Admissions: Dental Hygiene. Dental hygiene program directors reported accepting those who have completed a certain number or type of prerequisite courses in, for example, anatomy, physiology, and chemistry. Some indicated that they accept only those with the highest GPAs, especially in the sciences. Another program looks at time spent observing in a dental office, along with the GPA in science courses. Some reported using a point system that emphasizes the sciences and high academic standing. Two programs reported having a requirement that in order to gain admission to the dental hygiene program one must already be a dental assistant. One other program reported having dropped that requirement.

When asked if their enrollment has changed over the past five years, nearly all of the dental assisting program directors reported an increase, while most of the dental hygiene program directors said that their enrollment has remained at approximately the same level. Some volunteered that their applicant pool has grown.

Information about Program Graduates’ Practice Location. In general, programs located in more urban areas (except for the University of Minnesota) said that their graduates tend to remain in the area. Understandably, many University of Minnesota graduates move outside of the Twin Cities because that program attracts students from a broad geographic area. Programs located in smaller communities reported higher percentages of their graduates moving away after program completion. One director noted that a graduate’s decision about where to settle often is closely tied to where the spouse locates for work.

Program Needs. All of the program directors reported one kind of a need or another. Some dental hygiene programs requested funding for new or upgraded equipment such as digital radiography and intraoral cameras. Others said that scholarships and loan forgiveness programs would help. Still others noted a need for well qualified faculty and dentists to observe as clinic supervisors or even to fill in on short notice when regular clinic faculty are ill or need time off. Dental assisting program directors asked for dental office externship sites for their students, a placement service to help students find jobs after graduation, and financial support for restorative and other clinical equipment, along with software for digital radiography.

Discussion

This survey was conducted very inexpensively. Nominal costs included time and effort on the part of the MDA Dental Education Committee members and MDA staff, along with postage, letterhead, and copying to mail the cover letter, questionnaires, and return envelopes. Yet the project has provided the MDA with useful information that could help our allied dental professional programs remain and grow stronger, something that would benefit all of us. It is hoped that by disseminating the survey results — through this article, for example — MDA members will gain a better understanding of the programs and discover ways in which they may support them. It is the intent of the committee to continue to collect information in this way over a number of years in order to identify trends in allied dental education and to stay current with program needs.

Program Recruitment. It could be speculated that programs reported needing little help with recruitment because allied dental professions have become more attractive in terms of salary, benefits, and scope of practice. However, one director commented that high school guidance counselors sometimes do not know about the current, favorable aspects of an allied dental career and therefore cannot impart this to potential applicants. Just knowing that such an “information gap” exists at a particularly critical juncture — high school students who are about to apply to colleges — should motivate dentists to “close the gap” by actively providing their local high schools with current, factual information about the benefits of choosing a career as a dental health professional. Similarly, dentists can actively promote dentistry and the allied professions to young patients and other students. Mentoring can be very rewarding for both the dentist and the student.

Admissions and Enrollment. Minnesota’s allied dental education programs are operating at a very high capacity, but some programs volunteered that they have suffered budget cuts. One program director told us that the college’s administration required an increase in enrollment in order to boost revenue. But if the facilities and faculty are not ready to handle such increases, then it is reasonable to expect the attrition rate to increase in the future, at least in programs facing this kind of administrative pressure.

Some Minnesota dentists have voiced concerns over a shortage of registered dental assistants. Moreover, some believe that the problem is exacerbated by dental hygiene programs requiring enrollees to be dental assistants. Two programs still have this requirement. Moving from dental assisting into dental hygiene is a relatively common career path. It is unknown to what extent dental assisting program graduates go directly upon graduation into a dental hygiene educational program, or whether they spend a number of years practicing dental assisting first before entering a dental hygiene program. Future studies could examine this.

Dental Assisting Curricula. The MDA survey did not ask for information about curricula. However, one dental assisting program director volunteered that faculty are concerned about the ever-increasing number of expanded duties that must be taught (as a result of new rules promulgated by the Board of Dentistry or enacted by the state legislature). In fact, many educators and others share that same concern: How can programs fit new coursework into already full curricula? Some of the newer duties, like the restorative functions that are not required of all credentialed allied dental professionals, currently are being taught through continuing education courses. But, as more duties are added, perhaps it will be time to think about restructuring dental assisting education in order to preserve easy access to entry level positions yet provide a genuine career ladder within dental assisting for those who wish to advance.

Conclusions

Collecting pertinent, meaningful data from allied dental education programs can be done inexpensively and therefore routinely. Dentists can — and should — play an important role in ensuring that our allied dental professional programs have the support they need and request. Dentists may serve as clinic supervisors, faculty members, externship sites, and can work within their district dental societies to communicate program needs and opportunities. Mutually beneficial partnerships involving clinical practitioners, educators, and students will help to keep our programs and the dental team strong.