It has been stated there is a hygiene shortage, but we need more assistants, too.
This point about the oral healthcare workforce shortage cuts across all roles and is well taken. That is why there is no one solution to the difficult workforce situation we’re in. We have more patients to treat than we have care providers to treat them.
Specifically regarding dental assistants, the MDA has been working on a plan for more than a year to take a multifaceted approach to increasing the number of dental assistants, including:
We know EFDAs are the fastest way to respond to a workforce that has been debilitated by attrition during the COVID-19 pandemic. Experience with EFDAs in Missouri and Colorado has proven an EFDA can increase the productive capacity of a clinic by 12% or more. The MDA has been working with the Missouri Dental Board to streamline the EFDA process and remove bottlenecks. The Missouri Test of Basic Skills (a prerequisite for taking EFDA training) has been updated to ask more relevant questions and exam venues have been expanded; additionally, the MDA is hosting preparatory review courses to help dental assistants prepare the Exam.
The MDA supports efforts to lobby for increased funding for dental education in Missouri. Even though it will take a long time for increased funding efforts to actually impact the workforce, it’s another avenue we should take.
Career Centers/Vo-technical schools in rural areas of Missouri offer educational opportunities for high school students as well as adults already working in the community. The Office of Dental Health (ODH) would like to develop a 10-month educational pilot program for high school juniors and seniors that would allow the students to graduate with a dental assisting certificate and complete their Basic Skills Exam. If the high school juniors completed their Basic Skills Exam, then they can continue their education and earn their Expanded Functions Dental Assisting (EFDA) certificates as seniors. The didactic ("book" learning) portion of the program would be delivered in the school classrooms and the majority of the "hands-on" portion would be in dental offices. The clinical observation/internship would be arranged with local dental offices and Federally Qualified Health Care Centers (FQHCs) in the area. After completing their requirements and evaluations in the dental offices, the students have the potential of job opportunities after graduating from high school and the program.
Once the program is established, ODH would like to offer the didactic portions of the program to rural areas, utilizing Teledentistry, across the state to address the dental assistant shortage across Missouri. Ideally, all the didactic modules would be filmed and provided by synchronous and asynchronously to other parts of the state and the “hands on” portions would be provided in local dental offices and FQHCs. With the program offering the EFDA training, this will increase the student's skill set and their ability to make dental offices more efficient and able to serve more patients. This EFDA training provided in the second year of the training would specifically teach the EFDA Restorative I and II courses, as well as the Removable and Fixed Prosthodontic modules. With the addition of Restorative and Prosthodontic EFDA certification, productivity for the dentists has increased as much as 15%, which increases access to care.
Specifically regarding hygienists, the MDA has long supported RDH education programs across the state, including past donations to start or maintain programs, some of which subsequently closed. Most recently the MDA advocated for continuance of the UMKC School of Dentistry RDH program (and asked our members to do so) as closure was being considered as part of the 2020 UMKC Forward initiative.
The MDA has and continues to advocate for an increase in hygienists graduating in Missouri, however some of the circumstances around this are beyond MDA’s control, as they are decisions made by educational institutions and their governing bodies.
Currently MDA is working with 19 other states to lobby the Commission on Dental Accreditation (CODA) to lower the faculty-to-student ratio at CODA-accredited dental hygiene programs. The current faculty to student ratio in hygiene programs is higher than any other dental education program, including that for dental education. We believe this change would help ensure the viability of current programs and could allow programs to increase their class sizes without a decrease in quality of education.
MDA will also be reviewing its support on several other workforce related matters including, Dental and Dental Hygiene Compacts, legislation to allow foreign trained practitioners to provide hygiene care and new models for dental hygiene education. All areas that can assist with the severe shortage of dental team professionals will be researched and explored.