THE UTAH MEDICAL EDUCATION COUNCIL UTAH'S DENTIST

THE UTAH MEDICAL EDUCATION COUNCIL

UTAH’S DENTIST WORKFORCE, 2017:

A Study on the Supply and Distribution of Dentists in Utah

UTAH’S DENTIST WORKFORCE, 2017:

A STUDY ON THE SUPPLY AND DISTRIBUTION OF DENTISTS IN UTAH

The Utah Medical Education Council

State of Utah

www.utahmec.org

2017

Prepared by:

Jenna Christensen

Utah’s Dentist Workforce, 2017: A Study of the Supply and Distribution Dentists in Utah

Printed in the United States of America

Internet Address: www.utahmec.org

This publication cannot be reproduced or distributed without permission. Please contact the

UMEC at juolson@utah.gov or call (801) 526-4550 for permission to do so.

Suggested Citation:

Utah Medical Education Council (2017). Utah’s Dentist Workforce, 2017: A Study of the Supply

and Distribution of Dentists in Utah. Salt Lake City, UT.

THE UTAH MEDICAL EDUCATION COUNCIL

The Utah Medical Education Council (UMEC) was created in 1997 out of a need to secure and

stabilize the state’s supply of health care clinicians. The enabling legislation authorized the

UMEC to conduct health care workforce research, to advise on Utah’s health care training

needs, and to influence graduate medical education financing policies. In addition, UMEC

facilitates the training of healthcare professionals in rural areas of the state. The state

legislature expanded UMEC’s research responsibilities in 2013 to include nursing and UMEC has

accepted the designation as the Nursing Workforce Information Center. The UMEC is presided

over by an eight-member board appointed by the Governor to bridge the gap between the

public and private health care workforce industry and educational interests.

Members of the UMEC include:

Wayne Samuelson, M.D. (Chair)

Vice Dean

School of Medicine

University of Utah

John Berneike, M.D.

Director, Family Practice Residency Program

Utah Health Care Institute

Mark Hiatt, M.D., MBA, MS

Executive Medical Director

Regence BlueCross BlueShield of Utah

Sue Wilkey

Public Member

Paul Karakovitz, M.D.

Associate Chief Medical Officer

Intermountain Healthcare

Larry Reimer, M.D.

School of Medicine

University of Utah

Mary Williams

Public Member

Gar Elison

Public Member

iii

ACKNOWLEDGEMENTS

This study of Utah’s dentist workforce is based on a survey completed in 2017 by the Utah

Medical Education Council (UMEC) with assistance from the Utah Division of Occupational and

Professional Licensing (DOPL). Additional support was provided by the University of Utah and

Roseman University of Health Sciences.

The UMEC would like to thank its staff and the following members of the Dentist Workforce

Advisory Committee for their time and expertise in developing this report:

Richard Engar, DDS

Chief Executive Officer

Professional Insurance Exchange Mutual, Inc.

Wyatt Rory Hume, DDS, Ph.D.

Dean, School of Dentistry

University of Utah

Frank Licari, DDS, MPH, MBA

Dean, College of Dental Medicine – South Jordan

Roseman University of Health Sciences

Kim Michelson, DDS

State Dental Director

Utah Department of Health

Val Radmall

Executive Director

Utah Dental Association

Contents

LIST OF TABLES ............................................................................................................................................. vi

LIST OF FIGURES ........................................................................................................................................... vi

EXECUTIVE SUMMARY .................................................................................................................................. 1

POLICY RECOMMENDATIONS ....................................................................................................................... 3

METHODOLOGY ............................................................................................................................................ 5

License Data .............................................................................................................................................. 5

Design of Survey Instrument ................................................................................................................... 5

Data Collection ......................................................................................................................................... 5

Data Entry and Analysis ........................................................................................................................... 5

Survey Limitations .................................................................................................................................... 5

INTRODUCTION AND BACKGROUND ............................................................................................................ 7

LICENSED IN UTAH ........................................................................................................................................ 8

Dentist-to-100,000 Population Ratio ....................................................................................................... 9

DEMOGRAPHIC CHARACTERISTICS ............................................................................................................... 9

Age ............................................................................................................................................................ 9

Gender .................................................................................................................................................... 10

Race and Ethnicity .................................................................................................................................. 11

Upbringing .............................................................................................................................................. 12

Education Background ........................................................................................................................... 12

PRACTICE CHARACTERISTICS ....................................................................................................................... 15

Specialty.................................................................................................................................................. 15

Practice Setting ....................................................................................................................................... 15

Geographic Distribution ......................................................................................................................... 17

Practice Hours......................................................................................................................................... 19

Provider Accessibility ............................................................................................................................. 21

Gross Production and Net Income ......................................................................................................... 24

PATIENT DEMOGRAPHICS ........................................................................................................................... 27

Patient Age ............................................................................................................................................. 27

Insurance ................................................................................................................................................ 28

TRAINING CAPACITY .................................................................................................................................... 31

WORKFORCE PROJECTIONS ........................................................................................................................ 33

CONCLUSION ............................................................................................................................................... 35

POLICY RECOMMENDATIONS ..................................................................................................................... 36

APPENDIX A – BIBLIOGRAPHY ..................................................................................................................... 38

APPENDIX B – SURVEY INSTRUMENT .......................................................................................................... 40

LIST OF TABLES

Table 1: Factors Influencing Decision to Practice in Utah ............................................................................ 9

Table 2: Specialty Breakdown, 2012 and 2017 ........................................................................................... 15

Table 3: Practice Setting, 2012 and 2017.................................................................................................... 16

Table 4: Workforce and Population Distribution by County ....................................................................... 18

Table 5: Hours per Week by Specialty ........................................................................................................ 20

Table 6: Mean Hours per Week by Gender and Full-Time/Part-Time Status ............................................. 20

Table 7: Mean Patients per Week by Specialty .......................................................................................... 21

Table 8: Mean Patients per Week by Setting .............................................................................................. 21

Table 9: Median Gross Production and Net Income by Specialty, 2012 and 2017 ..................................... 26

Table 10: FTE Adjusted Median Gross Production and Median Net Income.............................................. 26

Table 11: Insurance Type Mean of Gross Production by Rural/Urban Practice ......................................... 28

LIST OF FIGURES

Figure 1: Practice Status of Licensed Dentists in Utah .................................................................................. 8

Figure 2: Dentist Age Distribution ............................................................................................................... 10

Figure 3: Gender Breakdown ...................................................................................................................... 10

Figure 4: Gender by Age Group .................................................................................................................. 11

Figure 5: Racial Composition of Utah Dentist Workforce, Utah Population, ............................................. 12

Figure 6: Current Dental School Debt (Current Debt > $0) ......................................................................... 13

Figure 7: Median Debt at Graduation and Median Current Debt by Age Group ........................................ 14

Figure 8: Percent of Practice Ownership/Partial Ownership by Setting ..................................................... 16

Figure 9: Practice Ownership Status by Race, Ethnicity, and Gender ......................................................... 17

Figure 10: Rural/Urban Breakdown of Dentist Workforce and Utah Population ....................................... 19

Figure 11: Wait Time in Days by Practice Setting ....................................................................................... 22

Figure 12: Wait Time in Days by Counties with Highest Means ................................................................. 23

Figure 13: Breakdown of Gross Production for All Dentists ....................................................................... 24

Figure 14: Breakdown of Net Income for All Dentists ................................................................................ 25

Figure 15: FTE Adjusted Income and Production by Gender ...................................................................... 27

Figure 16: Dentists Accepting New Insurance by Rural/Urban Practice ..................................................... 29

Figure 17: Reasons for Not Accepting New Medicaid Patients (n=1,408) .................................................. 29

Figure 18: Groups Receiving Charity Care ................................................................................................... 30

Figure 19: Gender Breakdown of Classes of 2018-2021 at Utah Dental Schools ....................................... 31

Figure 20: Racial/Ethnic Breakdown of Classes of 2018-2021 at Utah Dental Schools .............................. 32

Figure 21: In-State vs. Out-of-State Status of Classes of 2018-2021 at Utah Dental Schools .................... 32

Figure 22: Total Average FTEs Needed per Year ......................................................................................... 34

Figure 23: Average Supply per Year ............................................................................................................ 34

EXECUTIVE SUMMARY

• The Utah dentist workforce has grown by about 31.6% since UMEC started tracking the

workforce in 2002. Much of that growth (27.1%) took place after 2006 with the

workforce increasing from 1,467 active practitioners to 1,865 in 2017. The Bureau of

Labor Statistics (BLS) estimates that the national dentist workforce will grow faster than

average at about 18.0% between 2014 and 2024 (Bureau of Labor Statistics, 2015).

• The dentist to 100,000 population ratio has increased from 58.4 to 59.7 since 2012. This

is just below the national ratio of 61.7. When adjusting for hours worked, the Utah ratio

falls slightly to 58.6.

• The average age of the Utah dentist workforce is 51.3, up from 48 in 2012. This is

keeping with the national mean of 50.

• The Utah workforce falls far short of the national workforce in gender distribution with

4.1% of the Utah workforce made up of female dentists compared to 28.9% of the

national workforce.

• Both the Utah workforce and the national workforce are unevenly distributed when it

comes to race and ethnicity. The minority group with the largest population to dentist

gap is Hispanics, only comprising 1.9% of Utah dentists but 13.7% of the Utah

population.

• About half (49.8%) of all dentists report spending the majority of their upbringing in

Utah with only 13.9% reporting growing up outside of the state, though this question

did have a high non-response rate.

• Nebraska was cited as the single largest training source of Utah dentists with 15.4% of

the workforce attending dental school there. California was close behind at 10.5%. Most

dentists (53.6%) attended a public university while 44.9% attended a private university.

• Most dentists (57.3%) currently have no dental school debt, likely a result of age,

although the median amount of total dental school debt at the time of graduation is

$117,000. Among those who currently still have some educational debt, graduates of

public institutions graduated with a median of $232,000 while private institution

graduates had a median of $249,000 at the time of graduation.

• Only 15.3% of dentists currently participate or previously participated in a loan

reimbursement program. Rural dentists reported a higher rate than urban dentists

(20.0% and 14.9%, respectively).

• The share of the workforce in general dentistry has remained unchanged since 2012 at

77.8%. Rural dentists go into general dentistry at a rate of 85.7%. After general

dentistry, the most popular specialty is orthodontics at 6.3% of the workforce followed

by pediatric dentistry with 5.2% of the workforce.

• The share of dentists in group practice settings has grown rapidly since 2012 from 18.4%

to 30.1%. Solo private practices have shrunk from 76.9% to 60.8%. While the American

Dental Association doesn’t collect data on practice settings, other research suggests that

the trend towards group settings is a national phenomenon.

• The vast majority (82.0%) of dentists report being an owner or partial owner of their

primary practice setting. There is some variation based on race, ethnicity, and

particularly gender, with only 48.7% of female dentists reporting being owners or partial

owners.

• The geographic distribution of the dentist workforce is skewed towards urban areas,

with 11.1% of the workforce practicing in rural counties and 15.4% of the general

population living in rural counties.

• Dentists work an average of 35.3 hours per week, including both primary and secondary

practices. Variation stands out when breaking those numbers down by specialty, setting,

and gender.

• Dentists see an average of 79.2 patients per week and have a mean wait time of 5.0

days for new patients and 5.6 days for established patients. Wait time variances are

found between settings as well as county.

• The median gross production for all dentists is $594,000. Adjusted for full time

equivalent (1 FTE = 36 hours per week), gross production increases to $604,000. Rural

and urban gross production differs by close to $100,000.

• Median income for all dentists is $155,000. Adjusted for FTE, median income rises

slightly to $158,000. Rural dentists on average make $17,000 less than urban dentists

when adjusting for FTE.

• There is a statistically significant difference between the FTE adjusted incomes of male

dentists and female dentists. However, some of that difference may be explained by

setting, specialty, and years of experience. These numbers were not able to be analyzed

because of the lack of female dentists in the workforce.

• Patients with private insurance and those who pay out of pocket make up about 93.6%

of gross production for all dentists, with slight variation between urban and rural

practices. Only 28.1% of dentists take Medicaid and 22.8% report accepting new

Medicaid patients.

• With two new dental schools in Utah, the state has a capacity to train and graduate up

to 134 new dentists per year. With retirement, hour reductions, and population growth,

these two programs will likely provide the majority of needed dentists in the state,

estimated to be between 89 and 101 new FTEs per year for the next 10 years.

POLICY RECOMMENDATIONS

1. Improve Access to Dental Care. Although the dentist-to-population ratio in Utah is

similar to that of the nation, 24 of the state’s 29 counties are designated as full or partial

Health Professional Shortage Areas (HPSAs), likely resulting in skewed access to oral

health care.

a. Strengthen and promote loan reimbursement programs for dentists who

practice in rural areas and treat underserved populations.

b. Increase provider access through improved Medicaid reimbursement rates and

inclusion of preventative and restorative oral health services for adults enrolled

in Medicaid and Medicare programs.

c. Encourage and provide incentives to dentists participating in portable and

mobile service programs like the Family Dental Plan, student and resident

subsidized rotations, and other charity care drives.

d. Foster partnerships among Utah Area Health Education Centers (AHEC), Utah

Center for Rural Health, State Board of Education, pre-dental programs, and

dental programs to strengthen the dental education pipeline for rural and dental

students who are considering practices among underserved populations and in

rural areas.

2. Support the existing Oral Health Public Awareness through the Utah Department of

Health Oral Health Program. Promoting a public awareness campaign led by the Utah

Oral Health Coalition and the Utah State Department of Health Oral Health Program in

partnership with the two dental schools, the Utah Dental Association, the Utah Dental

Hygiene Association, and the various other oral health champions in Utah is crucial to

addressing the oral health access and policy concerns in Utah.

3. Support Oral Health Integration. Oral health has an impact on the overall health of an

individual, yet largely remains separate from primary care. Early intervention through

integration is increasingly necessary in preventing and treating oral health issues.

a. Encourage more dentists and primary care providers to participate in primary

care-dentistry referral networks.

b. Encourage the various primary care and dental training programs in the state to

engage in interprofessional training.

c. Engage with organizations such as the National Interprofessional Initiative on

Oral Health in order to facilitate oral health integration in the state.

4. Promote a More Diverse Workforce. Only 4.6% of the Utah dentist workforce identifies

as a racial or ethnic minority, compared to 21.0% of the population in the state.

Increasing diversity can help ensure that the oral health needs of an increasingly diverse

state are being met.

a. Develop and/or strengthen the admissions criteria for minority applicants and

cultural competency training for students in the two dental schools in Utah.

b. Encourage the two dental schools and the Utah Legislature to develop

scholarships and loan reimbursement programs for minority students.

c. Foster partnerships among the Area Health Education Centers (AHEC), the State

Board of Education, the Utah Board of Regents, high schools, pre-dental

programs, dental programs, and non-profit organizations such as the Boys and

Girls club and United Way to strengthen the dental education pipeline for

minority students.

5. Address the Gender Imbalance in the Utah Dentist Workforce. While the national

workforce has seen a major shift towards more female dentists, the Utah workforce has

yet to catch up. Although young dentists are made up of more women than older

dentists, there is still much to be done before Utah catches up with the nation.

a. Increase efforts to recruit and retain more female dentists in Utah and at the

two dental schools in the state.

b. Partner with women’s organizations in the state such as the Utah Women and

Leadership Project (UWLP) in order to understand and address the causes of the

lack of female dentists in the state.

c. Foster partnerships among the Area Health Education Centers (AHEC), the State

Board of Education, the Utah Board of Regents, high schools, pre-dental

programs, dental programs, and non-profit organizations such as the Boys and

Girls club and United Way to strengthen the dental education pipeline for female

students.

6. Enhance Data Collection in Order to Assess and Meet Changing Workforce Needs. The

UMEC has tracked the supply of dentists for many years, however additional data is

needed in order to make an accurate prediction of the demand for dentists in the

future.

a. Develop a system that periodically assesses demand and need for dental services

in Utah. This system could include need for services, service availability and its

utilization, quality outcomes, and sustainability in the state.

b. Retention rates of the dental school graduates in Utah should be closely

monitored along with practice location choices to measure their impact on

Utah’s workforce supply and distribution.

c. Create and support a partnership between the UMEC, the Utah Dental

Association, and the Professional Insurance Exchange to collect and utilize

retirement data in order to form a more robust workforce projection model.

METHODOLOGY

License Data

The Utah Division of Occupational and Professional Licensing (DOPL) provided the UMEC with

information for every licensed dentist in the state. As of January 2017, there were 2,914

dentists holding a license in Utah.

Design of Survey Instrument

In the design of the 2017 Dentist Workforce Survey, the previous UMEC dentist survey from

2012 was analyzed and revised based on the UMEC Dentist Workforce Advisory Committee

recommendations as well as streamlining questions to more easily compare to other healthcare

workforces in the state. The UMEC utilized Snap Surveys software for the design of the survey

instrument.

Data Collection

The first mailing was done in February of 2017. Respondents were tracked and a second mailing

was sent to those who had not returned the survey in April 2017. A third mailing was sent in

June 2017 to those who had not responded. Data collection was completed on July 10, 2017. A

total of 1,480 surveys were returned for a 50.8% response rate. With such a high response, the

analysis has a confidence interval of 95% +/- 1.8%. Survey responses were given a weight of

1.969 to account for non-respondents.

Data Entry and Analysis

The 2017 Dentist Workforce Survey was processed in house using Snap Surveys software. Data

entry was completed by the software and in-house by UMEC staff. Once the data entry was

complete, the information was imported into SPSS for statistical analysis. Analysis began in July

2017.

Survey Limitations

The survey asked dentists how much of their gross production was made up by different

insurance types. This did not allow analysis to be done on the patient insurance breakdown

itself. For example, one dentist wrote on his/her survey that 35% of patients had Medicaid but

only accounted for 10% of gross production.

When asked how many days a patient must wait for an appointment, a handful of dentists

distinguished between hygiene, restorative, and/or emergency patients. It is unclear if the

differences between these groups affected the overall mean. Similarly, when asked how many

patients were seen per week, some dentists distinguished between hygiene and oral exams.

Dentists were asked the number of dental assistants, dental hygienists, and office/admin staff

at their primary practice setting as well as the total hours per week for all staff in those

categories. It was clear that while many dentists totaled the hours per week, many also

averaged each employee. Because of the amount of reporting errors, this data was unable to be

analyzed.

INTRODUCTION AND BACKGROUND

The Utah Medical Education Council has been charged with conducting periodic analyses of the

medical professions in the state of Utah in order to assess workforce supply and demand. In

2002, UMEC published its first dentist workforce profile. The UMEC has subsequently published

two more dentist workforce reports based on surveys conducted in 2006 and 2012.

The dental workforce continues to grow across the state. While the dentist-to-population ratio

has been increasing since the UMEC published its findings in the 2006 report, the dentist

workforce itself continues to be distributed unevenly, particularly among rural and underserved

communities. This, combined with the lack of dental coverage among the general Medicaid

population, has led to uneven access to dental services across the state, despite the robust

growth.

LICENSED IN UTAH

As of January 2017, there were 2,914 dentists licensed in Utah. Of those, 1,865 (64.0%) provide

services in the state, a net growth of 11.9% since 2012. Of the remaining 1,049, 30.1% (876)

provide no services in Utah, 5.1% (150) are retired and provide voluntary or occasional services

in Utah, and 0.8% (24) responded as “other” status. Unless otherwise noted, this report refers

to the 1,865 dentists who provide services in the state.

Figure 1: Practice Status of Licensed Dentists in Utah

The survey asked the 876 dentists who did not provide any services in Utah what factors

influenced their decision to practice elsewhere. About half (50.1%, 429) cited low wages or

other issues having to do with market saturation while over 20% cited family (26.7%, 234),

lifestyle (21.3%, 187), and dental school debt load (20.4%, 179). Only 2.9% (26) said they plan

on moving into the state in the future.

When asked what factors contributed to the decision to practice in Utah, 87.6% (1,634) of

dentists working in the state cited family reasons and 78.4% (1,461) cited lifestyle. Only 4.5%

(85) cited wages/pay scale as a reason to work in Utah.

I Do Not Provide Any

Services in Utah, 30.1%

Active Practitioner and/or

Dental School Faculty in Utah,

64.0%

Retired and Provide Voluntary or

Occasional Service in Utah, 5.1%

Other, 0.8%

Table 1: Factors Influencing Decision to Practice in Utah

Rank

Factor

Family

Lifestyle

Climate

Cost of Living

Pay Scale/Wages

Other

Dentist-to-100,000 Population Ratio

Utah has an active dentist-to-100,000 population ratio of 59.7 with an estimated 1,865 dentists

in the state and a population count of 3,123,607 as of 2016 (Kem C. Gardner Policy Institute,

2015). When breaking that number down by full time equivalent (1 FTE = 36 hours per week),

that number decreases slightly to 58.6 FTEs per 100,000. These ratios are fairly consistent with

the American Dental Association’s estimate of 61.7 dentists in Utah as well as the national ratio

of 60.8 dentists per 100,000. Adjusted for hours worked, the American Dental Association

estimates there are approximately 55.1 dentists per 100,000 (Munson & Vujicic, 2016). As for

regional comparisons, Utah ranks 5

out of 11 Western states, possibly creating a market in

neighboring states for dentists trained in Utah.

(Health Policy Institute & American Dental

Association, 2017).

DEMOGRAPHIC CHARACTERISTICS

Age

The average age for all dentists working in Utah is 51.3 years with a median age of 50. Rural

dentists tend to be somewhat younger at 49.7 years. Overall age has increased slightly since

2012 with a mean of 48 years and median of 46 years (Utah Medical Education Council, 2015),

and consistent with the national workforce, which has an average age 50 years (Health Policy

Institute & American Dental Association, 2016). Likewise, the breakdown of age is fairly

consistent with national data as shown in the chart below.

American Dental Association dentist to 100,000 population estimates for Western states are as follows: Arizona

53.9, California 76.8, Colorado 69.7, Idaho 55.9, Montana 60.5, Nevada 52.9, New Mexico 51.4, Oregon 67.9, Utah

61.7, Washington 71.6, Wyoming 53.1.

Figure 2: Dentist Age Distribution

Although the age breakdown of the Utah dentist workforce is largely spread out, 38.8% (723)

are aged 55 and over, which may have implications when those individuals begin to reduce

their hours and retire. However, another 35.4% (660) are under the age of 44.

Gender

The Utah dentist workforce continues to be overwhelmingly male. As of 2017, an estimated

4.1% (77) of the workforce is female, up from 2.5% in 2012 compared to 28.9% of the national

workforce. Additionally, 48.0% of all dental graduates in 2015 were women (Health Policy

Institute & American Dental Association, 2016). Locally, 28.6% of prospective graduates

between 2018 and 2020 at the University of Utah and 45.2% at Roseman University are women.

A majority (64.1%, 49) of female dentists are under age 45, compared to 34.1% (610) of male

dentists.

Figure 3: Gender Breakdown

5.3%

30.1%

25.9%

23.5%

15.2%

15.9%

22.8%

21.5%

24.8%

15.0%

Less than 35 35-44 45-54 55-64 65 and Older

Utah National

97.5%

95.9%

70.2%

2.5%

4.1%

28.9%

Utah 2012 Utah 2017 National 2015

Male Female

When breaking gender down by age, it is clear that the demographics are shifting among the

younger age groups, however compared to national graduation data, Utah is still behind

national numbers (Health Policy Institute & American Dental Association, 2016).

Figure 4: Gender by Age Group

Race and Ethnicity

The dentist workforce in Utah is predominantly White/Caucasian, with an estimated 95.5% of

the workforce reporting as such. Every major racial and ethnic minority group is

underrepresented based on the composition of the state population, with the biggest gap

among Hispanics who account for 1.9% (35) of the dentist workforce and 13.7% of the

population in Utah (Kem C. Gardner Policy Institute, 2016). There were no dentists who

reported being Black/African American or Native American/Pacific Islander, however this simply

means that no dentists belonging to those racial groups responded to either that particular

question or the survey. While our data cannot estimate the breakdown of these two racial

groups within the workforce, they are likely underrepresented as well.

59.1%

84.1%

96.1%

93.4%

98.4%

87.2%

97.1%

99.8%

39.4%

15.5%

3.8%

6.7%

1.5%

4.8%

2.7% 2.7%

0.0%

25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 or older

Male Female

Figure 5: Racial Composition of Utah Dentist Workforce, Utah Population,

and National Dentist Workforce

*National dentist workforce data did not specify the breakdown of American Indian/Alaska Native and Native Hawaiian/Pacific Islander

populations.

Upbringing

A total of 49.8% (929) of Utah dentists reported spending the majority of their upbringing in the

state.

Other common states include California (4.5%, 85) and Idaho (2.3%, 43). An estimated

9.9% (185) spent their upbringing in one of the ten states in the Western region of the U.S.

other than Utah. Only 13.9% (260) indicated growing up outside of Utah.

Respondents were also asked whether they spent the majority of their upbringing in a rural,

suburban, or urban setting. Overall, 25.3% (473) grew up in a rural setting, 60.8% (1,134) grew

up in a suburban setting, and 12.4% (230) grew up in an urban setting.

Education Background

Only 1.5% (28) of Utah dentists attended a dental program in the state. This number will likely

increase over time as the state’s two dental schools age. Utah dentists cited Nebraska as the

location of their training program more than any other with 15.4% (287) of the workforce

followed by California with 10.5% (195) of the workforce. Ohio (7.5%, 140), Virginia (6.9%, 128),

Oregon (6.4%, 120) and Kentucky (6.4%, 120) were also common training states. A majority

This question had a non-response rate of 36.2%. The numbers reported include non-responses.

Arizona, California, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon, Washington, and Wyoming.

1.9%

0.5%

1.7%

0.5%

13.7%

1.0%

2.4%

1.0%

9.0%

1.9%

5.2%

15.7%

3.8%

1.1%

Hispanic American Indian/

Alaska Native

Asian Black Native Hawaiian/

Pacific Islander

Other

Utah Dentist Workforce Utah Population National Dentist Workforce

N/A*

N/A

N/A*

(53.6%, 1,000) attended a state university for their dental training while 44.9% (837) attended a

private university.

The median amount of educational debt for dental school was $117,000 at the time of

graduation. Over half (57.3%, 1,069) of all dentists indicated they currently have no dental

school debt, in large part due to the average age of the workforce. The current debt of the

remaining 41.2%

is vastly spread out.

Figure 6: Current Dental School Debt (Current Debt > $0)

Overall, those attending private universities graduated with more debt that those attending

state universities. Of all dentists, those with degrees from state universities graduated with a

median of $114,000 of dental school debt while those from private universities graduated with

a median of $127,000. When looking only at dentists who currently have dental school debt,

the amount of debt at the time of graduation rises to $232,000 and $249,000 for public and

private universities, respectively. The median amount of debt at graduation for dentists who

graduated since 2010 has risen drastically and is currently an estimated $365,000.

The mean age at the time of graduation is 29. Those aged 45 to 49 are the youngest age group

to have a median current debt of $0, suggesting it took those dentists between 16 and 20 years

to pay of dental school debt. However, it is unclear whether that estimate can be generalized to

This question had a 1.5% non-response rate.

3.0%

2.5%

3.0%

4.9%

3.4%

3.7%

2.6%

2.7%

1.4%

0.8%

1.2%

1.0%

0.6%

1.2%1.2%

1.7%

younger age groups due to the differences in the median amount of debt at the time of

graduation.

Figure 7: Median Debt at Graduation and Median Current Debt by Age Group

An estimated 15.3% (286) of dentists participate(d) in a loan reimbursement program. Military

and U.S. HHS National Health Service Corps programs were cited most often (5.5% and 2.1%,

respectively). When asked about willingness to work in an underserved area of Utah if dental

school debt load could be reduced, 27.0% (504) responded affirmatively.

Rural practitioners participate(d) in loan reimbursement programs at a slightly higher rate of

20.0% (41) compared to 14.9% (234) of urban dentists. Additionally, 36.2% (75) of rural dentists

stated they would be willing to serve in underserved areas if their dental school debt could be

reduced as opposed to 25.8% of urban practitioners.

$414,000

$340,000

$280,000

$229,000

$135,000

$105,000

$68,000

$53,000

$32,000

$410,000

$334,000

$175,000

$120,000

25 to 29

30 to 34

35 to 39

40 to 44

45 to 49

50 to 54

55 to 59

60 to 64

65 or older

Median Debt at Graduation Median Current Debt

PRACTICE CHARACTERISTICS

Specialty

An estimated 77.8% (1,451) of all dentists in Utah practice general dentistry, a percentage

which is unchanged from 2012. There is variation in general practice among rural and urban

dentists with 85.7% of rural dentists and 77.0% of urban dentists in general dentistry.

While most specialties remained relatively unchanged in terms of numbers from 2012, general

dentistry increase by an estimated 155 dentists and oral and maxillofacial surgery increased by

an estimated 25 dentists.

Table 2: Specialty Breakdown, 2012 and 2017

2012

2017

U.S. Workforce

General Dentistry

77.8% (1,296)

77.8% (1,451)

79.0%

Endodontics

3.0% (50)

3.2% (59)

2.8%

Oral and Maxillofacial Surgery

2.4% (40)

3.5% (65)

3.9%

Orthodontics

7.1% (119)

6.3% (118)

5.4%

Periodontics

1.6% (26)

1.6% (30)

2.9%

Pediatric Dentistry

5.8% (97)

5.2% (96)

3.7%

Prosthodontics

0.8% (13)

0.4% (8)

1.8%

Other Specialty

1.1% (19)

1.7% (32)

0.3%

Differences are found in specialty selection by gender. With so few women in the workforce it is

difficult to compare the gender breakdown specialty by specialty, however it is clear that

women go into general dentistry (84.6%, 65) at a higher rate than men (77.5%, 1,386).

Practice Setting

A majority of Utah dentists (60.8%, 1,134) work in a solo private practice. This is a decrease in

both the share of the workforce and actual numbers from 2012 with 76.9% and 1,328 dentists

working in solo private practices. Group private practices have seen the highest increase in

share of the workforce since 2012 from 18.4% to 30.1%. Nationally, the trend towards group

practices is stark as well (Decisions in Dentistry, 2016). The percentage of dentists who reported

having a secondary setting went up slightly from 19.5% (294) in 2012 to 21.1% in 2017 (394).

Dental Public Health was listed as a specialty option, but with so few respondents, analysis regarding that

specialty has been excluded from this report.

Table 3: Practice Setting, 2012 and 2017

2012

Primary

2012

Secondary

2017

Primary

2017

Secondary

Solo Private Practice

76.9%

7.7%

60.8%

5.7%

Group Private Practice – Small

18.4% 6.6%

26.8%

8.3%

Group Private Practice – Medium

2.9%

0.8%

Group Private Practice – Large

0.4%

0.6%

School Faculty

0.1%

1.0%

3.7%

3.2%

Govt. Agency/Armed Forces

0.3%

1.0%

0.7%

CHC/Low Income Clinic

0.9%

1.6%

1.5%

1.0%

Other

0.7%

1.6%

0.6%

0.7%

Community health centers and low income clinics continue to account for a very small

percentage of both primary and secondary practices. However, while only 1.1% of urban

dentists report CHCs as their primary setting, 4.8% of rural dentists report the same.

An estimated 82.0% (1,530) of dentists reported being an owner or partial owner at their

primary practice with only 15.9% (297) reporting being an employed dentist. This number varies

a great deal by setting from 96.4% of dentists in solo private practices to 7.1% of dentists in

Community Health Centers/Low Income Clinics.

Figure 8: Percent of Practice Ownership/Partial Ownership by Setting

96.4%

75.0%

46.2%

50.0%

7.1%

Practice - Solo

Group Private Practice - Small

Group Private Practice - Medium

Group Praivate Practice - Large

CHC/Low Income Clinic

Practice settings and employment status vary widely when looking specifically at female and

minority dentists. For example, 48.7% (37) of female dentists reported being an owner or

partial owner of their primary practice setting, while 83.5% (1,493) of male dentists reported

the same. Similarly, every reporting minority had a smaller percentage of ownership than white

dentists.

Figure 9: Practice Ownership Status by Race, Ethnicity, and Gender

Small group practices are most common among women (43.6%, 33) while solo practices

dominate among men (62.1%, 1,111). Because there are so few minority dentists, most

numbers breaking down practice setting by race and ethnicity are not reportable, however

Community Health Centers/Low Income Clinics and Group Practices are more common among

minority dentists than white dentists. These findings are consistent with the national workforce

(Decisions in Dentistry, 2016).

Geographic Distribution

Utah dentists report having primary practices in every county other than Daggett, Morgan,

Piute, Rich, and Wayne. However, a number of dentists reported a secondary practice in

Daggett, Rich, and Wayne, leaving only Morgan and Piute with no reporting dentists working in

the county. Twenty-four of Utah’s 29 counties are designated as a Dental Health Professional

Shortage Area (HPSA), including 4 geographic area HPSA counties and 21 low-income HPSAs.

82.9%

80.0%

75.0%

55.6%

48.7%

83.5%

15.5%

20.0%

25.0%

33.3%

14.5%

White American

Indian/Alaska

Native

Asian Hispanic Female Male

Owner/Partial Owner Employed Dentist

The table below outlines dentists working in each county in both primary and secondary

settings.

Table 4: Workforce and Population Distribution by County

Number of

Dentists

Percent of

Workforce

Percent of

Population

HPSA Designation

Beaver

0.2%

Low-Income Population

Box Elder

2.2%

1.8%

None

Cache

5.1%

4.1%

Low-Income Population

Carbon

1.7%

0.7%

Low-Income Population

Daggett*

0.04%

High Needs Geographic Area

Davis

210

11.3%

11.2%

Low-Income Population (Partial)

Duchesne

0.8%

0.7%

Low-Income Population

Emery

0.3%

Low-Income Population

Garfield

0.2%

Low-Income Population

Grand

0.3%

High Needs Geographic Area (Partial)

Iron

0.7%

1.7%

Low-Income Population

Juab

0.4%

Low-Income Population

Kane

0.2%

Low-Income Population

Millard

0.3%

0.4%

Low-Income Population

Morgan

---

0.4%

None

Piute

---

0.05%

High Needs Geographic Area

Rich*

0.08%

Low-Income Population

Salt Lake

815

43.7%

36.3%

Low-Income Population (Partial)

San Juan

0.8%

0.5%

Low-Income Population

Sanpete

1.4%

1.0%

Low-Income Population

Sevier

1.2%

0.7%

Low-Income Population

Summit

1.3%

None

Tooele

1.9%

2.1%

None

Uintah

1.1%

1.2%

Low-Income Population (Partial)

Utah

346

18.6%

19.8%

Low-Income Population

Wasatch

1.3%

1.0%

None

Washington

108

5.8%

5.2%

Low-Income Population

Wayne*

0.09%

High Needs Geographic Area (Partial)

Weber

195

10.5%

8.0%

Low-Income Population

Fewer than 5 dentists --- Zero dentists *Secondary practices only

As outlined in the table above, the dentist workforce is fairly evenly distributed among Utah’s

counties, despite the prevalence of HPSA designations. Iron, Morgan, Piute, and Utah counties

Although no dentist from Morgan County responded to our survey, an Internet search revealed 5 practices in the

county. It is unclear exactly how many dentists there are and which practices are primary vs. secondary practices.

all have a small dentist distribution shortage while Salt Lake County has a distribution surplus of

dentists.

When breaking down primary practice location by rural and urban county, it is clear that there

is a disproportionate number of dentists working in urban counties versus rural counties with

15.4% of the population in rural counties but only 11.1% of dentists in those same counties.

Figure 10: Rural/Urban Breakdown of Dentist Workforce and Utah Population

Practice Hours

The average dentist in Utah works approximately 35.3 hours per week. That number includes

hours worked at secondary settings as well, which consists of 17.3% (323) of the workforce. An

estimated 46.4% of dentists work full time, defined as 36 hours per week, while 49.2% work

part time, or less than 36 hours per week. Of those that work full time, the mean hours worked

per week jumps to 41.3 while part time dentist mean hours falls to 29.7 per week.

There is variation in hours worked when broken down by a number of variables. Looking at the

numbers by specialty, hours worked jumps from a mean of 27.3 hours per week among

Prosthodontics to just under 40 hours per week among Oral and Maxillofacial Surgery. These

variations tend to partially explain the variation in income as well.

Urban counties include Cache, Davis, Salt Lake, Utah, Washington, and Weber.

Rural,

11.1%

Urban,

84.4%

No Response,

4.5%

Utah Dentist Workforce

Rural,

15.4%

Urban,

84.6%

Utah Population

Table 5: Hours per Week by Specialty

Mean Patient

Hours/Week

Mean Total

Hours/Week

General Dentistry

33.3

35.4

Endodontics

35.0

36.1

Oral and Maxillofacial Surgery

38.6

39.7

Orthodontics

31.5

33.3

Periodontics

29.8

33.1

Pediatric Dentistry

33.4

35.8

Prosthodontics

26.0

27.3

Other

30.9

35.3

Variation also occurs when breaking hours worked down by age and gender. Younger dentists

tend to work more per week. For those under the age of 35, mean hours per week jumps to

about 38 and slowly decreases to 31.6 among dentists aged 65 or older. Similarly, female

dentists work less on average than male dentists (32.9 and 35.5, respectively). However, that

gap shrinks when comparing full-time and part-time dentists.

Table 6: Mean Hours per Week by Gender and Full-Time/Part-Time Status

Male

Male Count

Female

Female Count

Total

Full Time

41.4

831 (46.5%)

40.3

33 (43.6)

41.3

Part Time

29.8

874 (48.9%)

27.1

43 (56.4%)

29.7

Total

35.5

32.9

35.3

Provider Accessibility

Utah dentists see an average of 79.2 patients per week. This number is up from about 68.5

patients per week in 2012

. Patients seen per week can vary widely based both on specialty and

setting.

Table 7: Mean Patients per Week by Specialty

Specialty

Mean Patients per Week

General Dentistry

71.3

Endodontics

27.8

Oral and Maxillofacial Surgery

64.4

Orthodontics

171.6

Periodontics

60.5

Pediatric Dentistry

132.8

Prosthodontics

45.0

Total

79.2

Table 8: Mean Patients per Week by Setting

Setting

Mean Patients per Week

Solo Practice

69.6

Group Private Practice – Small

80.1

Group Private Practice – Medium

108.9

Group Private Practice – Large

145.0

Govt. Agency/Armed Forces

49.1

CHC/Low Income Clinic

56.2

Other

97.0

Total

79.2

In 2012, this question was asked on a patients per month basis while 2017 asked patients per week.

The mean wait time is 5.0 days for new patients and 5.6 days for established patients. This

number varies by practice setting and county. Among practice setting, CHC/Low Income Clinics

have the highest wait times for both new and established patients while medium-sized group

practices have the lowest wait time for both new and established patients.

Figure 11: Wait Time in Days by Practice Setting

4.6

5.0

1.9

5.5

12.0

18.8

5.0

5.4

2.1

8.8

13.5

16.8

5.6

New Patients Established Patients

There is more variation when breaking wait time down by county. Six counties had mean wait

times for either new or established patients that were at least two days higher than the mean

for the state. San Juan had several clinics respond with wait times that were close to the mean

and several that responded much higher, thereby raising the mean significantly.

Figure 12: Wait Time in Days by Counties with Highest Means

When asked about providing services in a language other than English, 59.6% (1,111) of dentists

responded that they could provide non-English services. A majority of all providers (52.2%, 973)

cited Spanish as one of the languages they could accommodate. Overall, minority dentists

reported being able to provide services in other languages more often than white, non-Hispanic

dentists.

10.0

14.0

11.6

40.0

8.6

4.6

5.0

2.0

7.0

8.0

39.5

6.4

10.0

5.6

Garfield Grand Millard San Juan Summit Washington Total

New Patients Established Patients

Gross Production and Net Income

The median gross production for all dentists in 2017 is $594,000. This has increased from

$534,000 in 2012. When adjusting for FTE, median gross production increases to $604,000.

Differences in FTE-adjusted gross production between rural and urban dentists is stark at

$524,000 and $621,000, respectively. While gross production among all dentists is spread out,

the bulk of dentists fall into the middle to low-middle range, with the exception of 5.0% (93)

falling above $1.5 million.

Figure 13: Breakdown of Gross Production for All Dentists

5.9%

8.0%

7.8%

10.0%

9.0%

9.4%

7.9%

5.8%

6.2%

5.8%

2.6%

2.1%

1.2%

5.0%

Under $100,000

$100,000 to $199,999

$200,000 to $299,999

$300,000 to $399,999

$400,000 to $499,999

$500,000 to $599,999

$600,000 to $699,999

$700,000 to $799,999

$800,000 to $899,999

$900,000 to $999,999

$1,000,000 to $1,099,999

$1,100,000 to $1,199,999

$1,200,000 to $1,299,999

$1,300,000 to $1,399,999

$1,400,000 to $1,499,999

$1,500,000 or more

The median net income for all dentists is $155,000. Net income has decreased from $159,000 in

2012. FTE-adjusted net income for 2017 is $158,000. Again, the difference in FTE-adjusted net

income between rural and urban dentists is stark at $144,000 for rural dentists and $161,000

for urban dentists. The pattern of net income distribution for all dentists mirrors that of gross

production distribution, with income concentrated towards the middle range and 11.8% of

dentists making $300,000 or more.

Figure 14: Breakdown of Net Income for All Dentists

5.6%

6.3%

9.9%

14.0%

10.0%

10.9%

9.6%

7.5%

3.5%

3.9%

2.3%

11.8%

Less than $50,000

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $124,999

$125,000 to $149,999

$150,000 to $174,999

$175,000 to $199,999

$200,000 to $224,999

$225,000 to $249,999

$250,000 to $274,999

$275,000 to $299,999

$300,000 or more

When looking at gross production and net income by specialty, several things stand out. The

only specialties to decrease in gross production overall are prosthodontics and other specialties

not listed. The overall net income decreased by about $3,000, although the only specialties to

see a decrease in net income are general dentistry and endodontics.

Table 9: Median Gross Production and Net Income by Specialty, 2012 and 2017

2012

2017

Median Gross

Production

Median Net

Income

Median Gross

Production

Median Net

Income

General Dentistry

$145,000

$550,000

$140,000

Endodontics

$536,000

$234,000

$657,000

$192,000

Oral and Maxillofacial Surgery

$982,000

$259,000

$1,119,000

$341,000

Orthodontics

$704,000

$201,000

$784,000

$211,000

Periodontics

$694,000

$195,000

$871,000

$195,000

Pediatric Dentistry

$696,000

$219,000

Prosthodontics

$609,000

$153,000

$507,000

$239,000

Other

$532,000

$145,000

$342,000

$168,000

Total

$592,000

$158,000

$594,000

$155,000

When adjusting for FTE, median gross production goes up for all specialties other than oral and

maxillofacial surgery, periodontics, and pediatrics. FTE-adjusted median income similarly

increases for every specialty other than oral and maxillofacial surgery and prosthodontics.

Table 10: FTE Adjusted Median Gross Production and Median Net Income

FTE Adjusted Median

Gross Production

FTE Adjusted Median

Net Income

General Dentistry

$571,000

$144,000

Endodontics

$689,000

$207,000

Oral and Maxillofacial Surgery

$1,056,000

$291,000

Orthodontics

$801,000

$227,000

Periodontics

$815,000

$276,000

Pediatric Dentistry

$673,000

$222,000

Prosthodontics

$606,000

$268,000

Other

$309,000

$153,000

Total

$604,000

$157,000

Breaking income down by gender shows a stark difference between men and women, even

after adjusting for FTE. While the ratio of gross production to net income is similar, the actual

numbers are stark, as detailed in the graph below. There is a statistical significance in income by

gender when controlling only for hours worked per week

, however, specialty choice may be

able to explain at least a portion of the gap, as women go into general dentistry, a lower paying

specialty, at a higher rate than men (84.6% vs. 77.5%, respectively). That being said, the FTE-

adjusted median income for female dentists is still well below the FTE-adjusted median income

for all general dentists. The designation of being an owner or partial owner as opposed to an

employed dentist is also a possible explanation for the difference in income.

Figure 15: FTE Adjusted Income and Production by Gender

PATIENT DEMOGRAPHICS

Patient Age

On average, dentists see patients who are aged 18 to 44 more than any other age group,

accounting for 30.4% of total patients. Those aged 5 to 64 account for an average of 81.3% of

the patients seen. Patients aged 65 or older account for an average of 16.9% of patient panels

and 10.8% of the population (Perlich, et al., 2017).

The American Association of Pediatric Dentists (AAPD) and the Utah Department of Health

recommend that a child be taken for his or her first dental visit before the age of one.

P=.039

$161,000

$610,000

$119,000

$416,000

$158,000

$600,000

FTE Adjusted Median Net Income FTE Adjusted Median Gross Production

Male Female All

Approximately 22.1% (412) of dentists report seeing any child under the age of one. Of the

dentists who do see children under the age of one, 71.3% (301) report children that age

account for less than 5.0% of their patient panel.

Insurance

On average, the majority of a dentist’s gross production comes from private insurance (64.5%).

Self-pay follows at 29.1%, Medicaid at 6.9%, and CHIP at 2.8%

. Medicaid and CHIP account for

more gross production among rural dentists than urban dentists.

Table 11: Insurance Type Mean of Gross Production by Rural/Urban Practice

Rural

Urban

Total

Medicaid

10.2%

6.1%

6.9%

CHIP

4.0%

2.6%

2.8%

Self-Pay

29.4%

29.0%

29.1%

Private Insurance

60.1%

64.3%

64.5%

Less than a third of dentists (28.1%, 524) report accepting Medicaid at all, which only covers

adult dental care for pregnant women and those who are disabled. CHIP covers an estimated

1.7% of children in the state and 30.0% of dentists report CHIP accounting for at least 1.0% of

their gross production.

The vast majority of dentists report taking new fee-for-service and privately-insured patients

(91.1% and 82.5% respectively). Only 24.5% of dentists said they are accepting new Medicaid

patients and 28.3% said they are accepting new CHIP patients. Rural dentists reported

accepting new Medicaid and CHIP patients at higher rates than urban dentists.

The numbers listed are means for each category and therefore do not add up to 100%.

Figure 16: Dentists Accepting New Insurance by Rural/Urban Practice

When asked reasons behind not accepting new Medicaid patients, low reimbursement was

cited as influential more than any other reason, followed by cumbersome administrative work

and missed appointments.

Figure 17: Reasons for Not Accepting New Medicaid Patients (n=1,408)

40.0%

37.1%

86.7%

89.5%

15.2%

1.0%

22.8%

27.7%

82.9%

92.6%

21.0%

1.3%

Medicaid CHIP Other insured Fee for Service Charity None/Full

Rural Urban

63.2%

46.2%

40.4%

66.8%

89.6%

Missed Appointments

Slow Reimbursement

Patient Behavioral Problems

Cumbersome Administrative Work

Low Reimbursement

A majority of dentists (80.9%, 1,508) provide charity care other than insurance write-offs. Most

of that charity care is done in Utah with 69.6% (1,298) of dentists providing a median of

$10,000 worth of charity care. Only 6.5% of dentists provide charity care outside the state.

Most dentists (52.9%, 986) provide charity care specifically to low income individuals, which

may help offset the lack of coverage and accessibility with Medicaid and CHIP.

Figure 18: Groups Receiving Charity Care

42.4%

29.6%

52.9%

46.6%

7.5%

Children Senior Citizens Low Income Any Person in

Need

Other

TRAINING CAPACITY

Between the state’s two dental schools, Utah will soon be graduating approximately 134

students per year, 84 from Roseman University of Health Sciences and 50 from the University of

Utah. The University of Utah inaugural class of 2017 consisted of 20 students. The number of

students set to graduate in 2018 is 23, 28 in 2019, 46 in 2020, and 50 in 2021 and presumably

thereafter. Roseman graduated its first cohort in 2015 and increased its capacity from 80 to 84

for the class of 2020. The retention rate of these two programs is still unclear and it will be

important to monitor as 134 new dentists graduating per year has the potential to have a large

impact on workforce projections.

Although 48.0% of all dental school graduates nationwide in 2015 were women (Health Policy

Institute & American Dental Association, 2016), 28.6% of the University of Utah’s students are

women, which will likely affect the gender imbalance in the Utah workforce in the future. The

gender split at Roseman University over the next four graduating classes is much closer to the

national average at 45.2%, however with a much lower rate of in-state students (discussed

below), it is unclear how much this will affect the Utah workforce.

Figure 19: Gender Breakdown of Classes of 2018-2021 at Utah Dental Schools

Both the Utah workforce and the national workforce are underrepresented when it comes to

minority dentists. Nationally, only Asian dentists account for a higher workforce share than the

general population, while every minority in Utah is underrepresented. Minorities at both

schools are underrepresented in their student body, but minorities at Roseman University

account for 35.5% of future dental graduates while minorities at the University of Utah account

for 16.0%.

U of U Roseman U of U Roseman U of U Roseman U of U Roseman

Class of 2018 Class of 2019 Class of 2020 Class of 2021

Male Female

Figure 20: Racial/Ethnic Breakdown of Classes of 2018-2021 at Utah Dental Schools

Whether these schools choose to accept more students from Utah or from out of state will also

have an impact on the state’s workforce, as Utah students may be more inclined to stay in the

state. The University of Utah dental student body is much more skewed towards Utah students

while Roseman skews towards out of state students. This will likely have an impact on retention

rates, and therefore gender and minority breakdowns in the workforce, at both universities.

Figure 21: In-State vs. Out-of-State Status of Classes of 2018-2021 at Utah Dental Schools

2618

U of U Roseman U of U Roseman U of U Roseman U of U Roseman

Class of 2018 Class of 2019 Class of 2020 Class of 2021

Minority White

20 20

U of U Roseman U of U Roseman U of U Roseman U of U Roseman

Class of 2018 Class of 2019 Class of 2020 Class of 2021

From Utah From Out of State

WORKFORCE PROJECTIONS

Utah’s dentist to 100,000 population ratio of 59.7 is just short of the national ratio of 60.9. The

FTE-adjusted ratio of 58.5 is slightly over the national adjusted ratio of 55.1. The following

projection makes the assumption that the Utah ratios are adequate and should be kept over

the next ten years.

An estimated 57.8% (1,077) of the Utah dentist workforce plans on reducing their hours within

the next 10 years from an average of 35.3 hours per week to an average of 21.8. Additionally,

33.8% (630) of the workforce plans on retiring completely within the next ten years, with an

estimated 50.0% having already reduced their hours. The reduction in hours will account for an

estimated 24 FTE loss per year, while full retirement, comprised of both those who have

previously reduced their hours and those who haven’t, will account for an estimated 42 FTEs

lost per year.

While the UMEC survey collects data on dentist retirement intentions, the Professional

Insurance Exchange (PIE), which insures about 90% of dentists in Utah (excluding oral

surgeons), collects retirement data when dentists leave the workforce. Between 2014 and

2016, an average of 36 dentists per year canceled their policies due to retirement

. If we

assume PIE insures 90% of the workforce, this leads to an average yearly retirement of 38.

Using the same assumptions that half of the workforce has reduced their hours from an

average of 35.3 hours per week to 21.8 hours per week, this equates to an average of 30 FTE

losses per year due to retirement.

The population of Utah is projected to steadily increase over the next ten years from an

estimated 3.1 million in 2017 to 3.7 million in 2027. In order to accommodate this increase, the

average number of net FTEs needed each year is 35, bringing the total average number of FTEs

needed per year to replace FTE loss through hour reduction (24) and retirement (30 to 42) and

account for a growing population (35) to between 89 and 101.

Between Utah’s two dental schools, the state has the capacity to train and graduate 134 dental

students per year. However, not all graduates will remain in the state. Because both schools are

new and retention rates cannot be calculated as of yet, the UMEC has included four different

supply scenarios based on retention rates ranging from 50.0% to 65.0%. Depending on which of

the four retention scenarios matches closely with actual retention rates, Utah will have to

import between 1 and 34 FTEs into the state in order to meet the estimated need of 89 to 101

FTEs per year.

This included simple retirement as well as retirement due to mission service, disability, and leaving practice to

teach.

Figure 22: Total Average FTEs Needed per Year

Figure 23: Average Supply per Year

Population

Growth, 35

Pre-

Retirement

FTE Loss, 24

PIE Retirement Data, 30

Self Reported Retirement,

12 additional (42 total)

Roseman, 42

Roseman, 46

Roseman, 50

Roseman, 55

U of U, 25

U of U, 28

U of U, 30

U of U, 33

50%

Retention

55%

Retention

60%

Retention

65%

Retention

89 FTEs

101 FTEs

Outside Supply,

22 to 34

Outside Supply,

15 to 27

Outside Supply,

9 to 21

Outside Supply,

1 to 13

FTEs

101

FTEs

CONCLUSION

The Utah dentist workforce has grown in both numbers and in the dentist-to-population ratio.

The recent growth of the two dental school programs, as well as the continued growth of the

University of Utah’s program over the next few years, will likely be a major source of Utah

dentists in the future. However, retention rates need to be closely monitored in order to

integrate these future dentists into a more accurate projection model. Although the dentist-to-

population ratio is similar to national numbers and wait times are short, access to dental care

continues to be skewed, with few options for Medicaid, CHIP, and low-income patients, both in

terms of policies and providers.