Monday, February 08, 2016

Rural N.D. lacks dentists; ADA's chief economist says some rural residents don't see a need for care

While a 2014 report from the Center for Rural Health highlights a serious shortage of dentists in North Dakota's rural, under-served and Native American communities, some health professionals deny there is a problem or blame rural residents for lack of care, John Hageman reports for the Grand Forks Herald. The report found that 67 percent of all North Dakota dentists practiced in the state's four most-populated counties, where about 52 percent of the state's people live. That meant that in 2014, 12 of the 53 counties did not have a dentist, nine had only one and nine had two (data were unavailable for five counties). North Dakota ranks 48th in population but 19th in land area, making it difficult for many rural residents to travel to see a dentist.

Rob Lauf, a dentist in Mayville in rural Traill County, just outside Grand Forks, said he doesn't consider the eastern part of the state to have a dental shortage, Hageman writes. Lauf told him, "Either way, you have to have a full schedule. There are some counties that don't have a dentist, but they also don't have the population to support a dentist." The eastern part of the state includes two rural counties adjacent to Grand Forks and Traill counties—Nelson and Steele—that do not have a dentist, according to the Center for Rural Health report. (Center for Rural Health map: Dentists in North Dakota in 2014)
At the same time, an "American Dental Association survey showed that less than 10 percent of general and specialist dentists in North Dakota reported they are not busy enough and could see more patients in 2013, which was the lowest percentage of the 36 states included on the survey and well below the national average of roughly 35 percent," Hageman writes. Marko Vujicic, chief economist with the American Dental Association, "said the main reasons people don't seek dental care are cost and 'a perceived lack of need' rather than an inability to get a dental appointment scheduled."

North Dakota, which lacks a state dental school, has tried to recruit recent college graduates with loan repayment programs, Hageman writes. Legislation proposed last year allowing certified advanced dental hygienists to perform some procedures now done by dentists, a move designed to increase dental care needs in rural and Native Americans, was opposed by the North Dakota Dental Association and ultimately did not become law.

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