raised on the principle stated in Chapter 1 that a qualified dental work force is a valuable national resource. Its future is too important to be determined solely by the isolated decisions of individual universities and states.

Earlier sections of this report have also touched on work force issues. Chapter 2 briefly reviews the shift from the 1960s to the 1980s from concerns about an undersupply of dental practitioners to worries about an oversupply. Expansionist policies were adopted and then abandoned in favor of policies of neutrality or contraction. One legacy of the policy turnaround is a set of structures and processes for collecting work force and other data and forecasting future supplies and requirements for dental and other health professionals and services.

Chapter 5 discusses the oral health research work force and notes the shortage of qualified researchers. It cites the recent report of the Office of Science and Engineering Personnel of the National Research Council. That report concluded that at least 200 graduates per year were needed to meet the need for oral health researchers, and it noted that this is roughly four times the current production. The recommendation in Chapter 4 for an increase in the number of general dentistry residencies was intended not to increase the supply of generalists but rather to improve their qualifications.

Work Force Trends and Projections

Dentists

Numbers and Projections

More than 140,000 dentists are in active practice in the United States, and the ratio of dentists to population currently stands at approximately 56:100,000 persons. Forecasts of the numbers of dentists are generally consistent in predicting that the absolute number of dentists in the United States will peak around the year 2000 and then level off before beginning a gradual decline (AADS, 1989; ADA, Bureau of Economic and Behavioral Research, 1991; USDHHS, PHS, 1992). These projections are depicted in Figure 1.2 in Chapter 1. Because the U.S. population continues to grow, the ratio of dentists to the general population will drop earlier and more sharply, falling by 2010 to a estimated level of less than 50:100,000 (or approximately 2,000 people per dentist).

The projections in the dentist work force reflect the combined effect of the retirements of dentists trained in peak enrollment years



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