For the past year, leaders at East Carolina University have been promoting the idea that North Carolina needs second dental school, one that would be housed on the school’s campus. They have been able to rally the support of several legislators in the General Assembly, including Senate leader Marc Basnight and embattled Speaker of the House Jim Black. It is anticipated that a proposal for a new dental school will be discussed in the General Assembly’s upcoming short session.
Advocates of the plan say that there is a need for more dentists in certain areas of North Carolina, especially eastern North Carolina, and that a new school would help to alleviate that need.
Before legislators commit any state money to this plan, they should demand answers to two key questions. Is there really a shortage of dentists in any part of the state? If so, is building a new dental school the most efficient way of addressing that shortage?
They might begin by taking a look at dental education throughout the United States. There are 56 dental schools accredited by the American Dental Association in the U.S. and Puerto Rico. An interesting fact is that quite a few states don’t have even one dental school. (Among the states without a dental school are Delaware, New Hampshire, Maine, Kansas, both Dakotas, Montana, and Hawaii.) Of course, there are dentists in all those states; they get their training elsewhere.
If there are states with no dental schools, can North Carolina get by with only one?
In the market for dentistry, state boundaries don’t mean much. Competent dentists can get their state licenses wherever they decide to set up a practice. The place where they received their dental training is irrelevant.
What about the claim that eastern North Carolina has counties that are “underserved” by dentists? It’s true that there are eastern counties with few dentists – sometimes none. It’s also true that there are counties in central and western North Carolina with similar “shortages.” And there are eastern counties with numerous dentists. The conclusion to draw is that dentists will go where they believe they can establish a profitable practice.
Just because a county has a low number of dentists per capita doesn’t mean that the people who live there aren’t able to get dental services when they need them. People are, after all, mobile. When someone has a tooth problem, he’ll get to a dentist even if it means driving an hour to get there. People often drive at least that far to get to a shopping mall.
Legislators should also ask how the state has been faring with just one dental school. Between 2002 and 2006, there was a 14 percent increase in the number of licensed dentists. Over roughly the same period of time (2000 to 2005), state population grew by 7.8 percent. From those statistics, it certainly looks as though the state is doing just fine with regard to the number of dentists.
The initial cost of building the ECU dental school is put at $80 million. Since it appears that the state is able to meet the demand for dentists with the school at UNC-Chapel Hill plus dentists trained in other states who see good opportunities here, the expense is hard to justify.
Now what if we did build the new ECU school – would that necessarily mean more dentists in eastern North Carolina? No. Graduates from ECU would no more stay in that region than graduates of Chapel Hill’s dental school stay in the Triangle.
Construction of a new dental school appears to be a lot of cost to solve no real problem. That suggests that the motive may have much more to do with politics than with serving people’s needs. Last year, there was a proposal for a new optometry school at UNC-Pembroke that was justified on the same grounds as we have here – that part of North Carolina was “underserved” by optometrists. (See Clarion Call for April 7, 2005.) Fortunately, that plan was dropped when the cold light to reason was shone upon it.
This proposal looks to be just another way for powerful politicians to steer taxpayer money where they want it. The taxpayers of the state should no more have to pay for needless spending on education than they should have to undergo needless root canals.