By Laird Harrison, Senior Editor

January 22, 2008 -- If you build it, they will come. But will they stay? It's a key question faced by New Mexico legislators as they mull Gov. Bill Richardson's proposal to launch the state's first dental school.

Richardson proposed the school Jan. 15 in his State of the State address. "I’m recommending the creation of the first dental school in New Mexico to address our state’s gaps in oral health care," Richardson said, according to a text of the speech released by his office Web site. The proposal caught many people in the state by surprise; a dental school isn't even listed among the legislative priorities for the University of New Mexico for 2008.

Richardson's proposal lacked specifics, but he later asked the state Legislature to allocate $12 million to start a dental residency program at the University of New Mexico, some of which would be used to begin planning the dental school, according to an Associated Press report. The governor's office did not respond to requests for comment.

New Mexico has fewer dentists per person than most other states. In 2004 (the most recent year with statistics available), it had only 4.3 dentists per 10,000 people, compared to 6.0 per 10,000 for the country, according to the Web site

"And like most Western states, we have a distribution problem where dentists tend to congregate in urban areas," Mark Moores, executive director of the New Mexico Dental Association, told "So there's a problem of access to care in rural areas."

New Mexicans suffer from more dental disease than residents of most states; for example, 37 percent of third-graders there have untreated tooth decay, the sixth highest prevalence in the country.

New Mexico's population is one of the fastest growing in the country, and the state will need about 30 more dentists per year for the next two years, according to a 2003 estimate by L. Jackson Brown, D.D.S., Ph.D., associate executive director of the American Dental Education Association. Dr. Brown noted that building a school with only 30 students per class would be more expensive per student than larger schools which have economies of scale.

Dr. Brown doubts whether New Mexico could attract many students from other states, because there are already schools established in the region. Midwestern University this year opened a new dental school in neighboring Glendale, Arizona, with a projected class size of 100.

The New Mexico Dental Association has taken no position on the proposal for a new school. "The big question for the Legislature is going to be cost," said Moores. He said the governor planned to request $48 million for "bricks and mortar" and another $15 million in operating costs for the school.

In an editorial written before the state of the state address, the Albuquerque Journal argued that instead of a new dental school the state should increase its existing scholarship program. The state gives New Mexicans scholarships to study dentistry if they return to practice in New Mexico once they obtain their dental licenses; for every year of subsidy, they are required to practice a year in New Mexico.

After establishing their practices, most stay, said Moores. By contrast, he said, most graduates of the University of New Mexico School of Medicine practice in other states.

The Albuquerque Journal also argued for a new student loan program that would forgive a portion of the loan for each year that a dentist practiced in an underserved rural area.

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Copyright © 2008

Last Updated hh 5/6/2009 10:35:21 AM

1 comment so far ...
5/27/2009 11:01:55 AM
Dear Editor,

I am writing this letter with a simple solution to a huge problem that the residents of New Mexico are suffering from. My suggestion is based on the following data:

According to Oral Health America, an advocacy group that researched the dental deficiency, only 25 states and Washington, D.C. had sufficient number of dentists available for the general public. The remaining 25 states had only one dentist available for every 2,000 people.

There were 616 dentists, 560 dental hygienists, and 1,520 dental assistants practicing in New Mexico in 2000. There were 33.8 dentists per 100,000 populations in New Mexico in 2000, well below the national rate of 63.6. New Mexico ranks 49th in the nation in dentists per capita. The number of dentists in New Mexico increased 2% between 1991 and 2000 while the state’s population grew 18%. The result was a 13% decline in dentists per capita, in contrast to a 16% increase nationwide.

More recent information from the Geographic Access Data System (GADS) 2003, indicates 820 licensed dentists with a NM address for a rate of 44 dentists per 100,000 populations, still significantly lower than the national rate of 63.6 per 100,000 populations. (Quick facts 2004- Health Policy Commission)

Big billboard on I-25 can be seen with an 800 telephone number asking “New Mexico needs-Doctors, Nurses and Dentists”. It has been observed that the majority of the dentists in New Mexico, are over 40 years of age and will be reducing their dental practice and/or retiring in the next ten years. Only 6 dentists from the WICHE program (Professional student exchange program) have returned to NM after completion of their dental degree from the other states (The Commission on Higher Education reports).

During the 2001 legislative session, M.S. 150A.06, Subd. 1 was passed and signed into law. The law, which became effective on August 1, 2001, allows internationally-educated dental graduates to apply for Minnesota licensure. Specifically, the law states that: “A graduate of a dental college in another country must not be disqualified from examination solely because of the applicant’s foreign training if the board determines that the training is equivalent to or higher than that provided by a dental college approved by the Commission on Dental Accreditation of the American Dental Association or a successor organization.”
It is suggested that the NM may utilize a valuable resource that is being wasted; internationally educated dentists.

Some suggestions that NMBODHC could utilize to evaluate and license qualified internationally -trained dentist applicants:

• Use existing evaluation services to help in finding the equivalency of a foreign degree with a US degree.
• According to the dictionary definition of accreditation; "the granting of approval to an institution of learning by an official review board after the school has met specific requirements". ADA only allows foreign qualified dentists to sit in NDB examination when his/her degree is reviewed by an ADA recognized credentialing agency for equivalency to ADA-accredited dental program.

• If there is value in the national and regional dental board exams, successful completion of the exams should determine if a foreign-trained dentist is qualified. Just as the criteria used for the foreign medical applicants. I may suggest offering "USDLE" just like "USMLE".

• Require successful completion of one year of working under supervision in order to be granted a license, as that will be more beneficial to the dentist and to the patients than requiring one to sit in a classroom and learn things that they already know. This will also help in evaluating the capabilities of the dentist and also would help alleviate the dental shortage in the underserved population, thereby benefiting the community as well.
• Professional background checkup can be done through PBIS, Inc just as it is done for the local dentists.
Most of the international dental programs are 4-yrs duration just as USA dental programs. Most of them require pre-dental education. In USA the pre-dental education is 2-yrs minimum after high school because there is no structured option in the high school, while in most of the international education system, qualified candidates have the option of clear and structured pre-dental or pre-medical education incorporated in high school curriculum.

There are several ways to utilize my suggestion; License International Dental Graduates on the same criteria as U.S. Dental graduates, Temporary license with extension possibility, Limited license, Faculty dental practice License, underserved areas licensure, reciprocracy licensure etc.

Aamna Nayyar, DDS
Internationally qualified and California licensed dentist