Dental Hygiene Workforce in Iowa: Current Capacity and Implications for Access to Care for the Underserved
In Iowa and nationwide, oral health disparities are manifested in higher rates of disease and poorer access to care for the populations most in need. A key issue in the goal of oral health improvement for these populations is improving access to preventive services. In 2016, only 50% of Medicaid-enrolled children in Iowa received a preventive dental service. Dental hygienists’ (DH) scope of practice is primarily focused on the promotion of oral health and prevention of dental disease.
A survey of Florida DH found that among those currently practicing, 15% were seeking additional employment. We received similar reports of underemployment anecdotally after releasing a preliminary study of DH workforce in Iowa. Additionally, in the DH community, there is well-documented difficulty nationally finding full-time positions, resulting in most DH working more than one job. These indicators of potential underemployment are compounded by the fact that there is a projected surplus of DH in Iowa and nationwide in the coming decade, with a concurrent projected shortage in dentist workforce. If excess workforce capacity exists in Iowa, there may be opportunities to redirect this capacity toward improving access to preventive services for Iowa’s vulnerable populations.
Iowa is one of several states with a public health dental hygiene model in which hygienists can provide preventive services in public health settings without requiring a dentist on-site. This practice model offers an existing mechanism that could be expanded to increase potential entry points into the dental care delivery system. Thus, there is a need to examine the current and potential capacity of this unique subset of the DH workforce.
This report summarizes a project to examine the dental hygiene workforce in Iowa, and to determine the extent of underemployment of DH in the state. Project activities were guided by an advisory committee composed of Iowa stakeholders interested in oral health access and workforce issues.