16 May 2023

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Virginia Dental Association, other state orgs call for review of faculty-student ratios in dental education

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Nineteen state dental associations, including the Virginia Dental Association, sent a response letter to the Commission on Dental Accreditation (CODA) May 1, continuing to urge them to move forward with a review of faculty to student ratios in dental education programs.

CODA signaled that it is forming an Ad Hoc Committee to review faculty to student ratios within the Accreditation Standards and the 19 states requested additional information as to the scope and composition of the committee. 

In the letter, which was posted on the Virginia Dental Association website, the state dental associations said that they applaud CODA’s decision to form an Ad Hoc Committee to review faculty to student ratios. The associations asked for clarity on the scope of work of this committee and, more specifically, whether the following points from a Jan. 16, 2023 letter have been included in this scope:

• Establish an ad hoc group to draft a clear rationale for setting faculty to student ratios for all CODA Accreditation Standards for which faculty to student ratios exist. This ad hoc group should, at a minimum, consider the following factors:

        - Should there be variation in the faculty to student ratios in the Accreditation Standards based upon the complexity of procedures in which             students are being trained?

        - Should there be variation in the faculty to student ratios in the Accreditation Standards based upon technology used for training students?

        - At what ratio is ensuring appropriate technical instruction and evaluation compromised?

        - Are there any factors within the control of educational programs that warrant variance in the faculty to student ratios?

• Solicit robust feedback from the broader dental community on establishing rationale for setting faculty to student ratios for Accreditation Standards that include faculty to student ratios. ASCDE and other organizations will gladly assist CODA in this stakeholder effort.
• Ensure that faculty to student ratios in CODA’s Accreditation Standards that utilize faculty to student ratios are consistent with whatever rationale is finalized by the Commission.

The 19 state dental associations also requested information on the composition of the Ad Hoc Committee and the extent to which the work, deliberation, and development of a report will be transparent to stakeholders.

In addition, the associations outlined concerns about the dental workforce. 

In the letter, they wrote that the nation is facing a severe shortage of dental hygienists and assistants. This shortage was exacerbated by the COVID-19 pandemic. Currently, 95% of dentists seeking to hire a hygienist and 87% of dentists seeking to hire an assistant find the hiring process to be extremely or very challenging. A 2020 study by the American Dental Hygienists’ Association (ADHA) found that the pandemic resulted in a voluntary contraction of the U.S. dental hygiene workforce by an estimated 3.75%, or approximately 7,500 dental hygienists which is approximately equal to the number of dental hygiene graduates in one calendar between 2014-2019. Furthermore, an October 2022 study by the American Dental Association (ADA), ADHA, and the Dental Assisting National Board found one-third of the hygienists and assistant workforce indicated they expect to retire in five years or less. The severe shortage of hygienists and assistants is having a negative impact on access to care, with patients having to wait months to receive preventive dental care in both private practice and public health settings. 

Dental association leaders also said that in the next decade, data show that the dental allied health shortage will get worse without drastic action. According to U.S. Bureau of Labor Statistics (BLS), the number of dental hygiene and dental assisting jobs will grow faster than average between 2021-2031 (9% and 8% respectively) compared to dentist that will grow as fast as average (6%). The following table shows the BLS data for the number of annual job openings for each profession compared to the number of 2019 graduates from accredited programs according to the American Dental Education Association (ADEA).

The associations closed the letter by asking for additional information. 

More specifically, they asked when the faculty to student ratio was adjusted from 1 to 6 to 1 to 5? In addition, they would like to know what rationale was provided at the time that this adjustment was made and what public comments were submitted in support and in opposition to the adjustment? 

Read more on the Virginia Dental Association site. 

Learn more about the dental workforce from a recent presentation by the ADA Health Policy Institute at the AAE 2023 Annual Meeting.