LITTLE ROCK — Arkansas’ medical school is actively exploring the possibility of adding residency programs for dentists and, ultimately, a college of dentistry, with an eye on improving the number and distribution of dentists in the state.
In September, the University of Arkansas for Medical Sciences in Little Rock established the Center for Dental Education, said Dr. Charles Cranford, a dentist and special assistant to the chancellor for dental education initiatives.
Cranford is director of the center, which is planning the expansion of dental education and training in Arkansas at a time when a growing body of evidence shows that poor dental care can significantly affect a person’s overall health.
“We are on a track now to be able to open the first phase of our clinic in the fall,” he said, referring to a dental clinic UAMS plans to open on its main Little Rock campus, possibly as early as Sept. 1.
It takes about two years to get preliminary accreditation for a residency program, so it would be July 1, 2014, before UAMS could do that, should planning studies support the current thinking that a need exists, he said.
A new dentistry college would have to be started from scratch, rather than expanding an existing program, Cranford said.
“It’s certainly accurate to say it would be at least a five-year planning process before a college of dentistry could open here at UAMS,” he said.
Currently, roughly 9 percent of UAMS’ overall operating budget is publicly funded via state government appropriations, said spokesman Leslie Taylor.
The medical school has not sought state funding for the dental programs, as the planning process has not yet reached that point, Cranford said.
It received state seed money roughly five years ago when it began a Northwest satellite campus that expanded its existing Little Rock campus’ professional schools and residency programs, and continues to get state appropriations to support the medical satellite.
It did land a private grant to fund the long-range planning efforts.
UAMS announced the $150,000 award from the Blue and You Foundation for a Healthier Arkansas on March 6.
“It’s not something you can do overnight,” said the foundation’s executive director, Patrick O’Sullivan, of creating a major dental program, adding that UAMS’ seriousness was key. “We also got reassurance from UAMS when they submitted this proposal, that it was a priority for them.”
Besides UAMS’ College of Medicine - which educates students to become doctors before they go on to begin practice in residency, or physician training, programs - its other academic units are its College of Nursing, College of Pharmacy, College of Public Health, College of Health-Related Professions and Graduate School.
Cranford, who at one time had served as UAMS’ vice chancellor for regional programs and executive director of its state Area Health Education Centers system for 23 years, recalls he had planned to retire.
But when Daniel W. Rahn became chancellor in 2009, he expressed an interest in developing a dentistry college. Cranford, whose career had included passion and experience in hospital dentistry and multidisciplinary dentistry, was intrigued.
Today, at age 77, he finds himself heading this new effort for Rahn.
“Arkansas has the largest population of any state without a college of dentistry,” Cranford said.
According to a listing by the American Dental Education Association, Arkansas is among 14 states that offer no predoctoral dental education program.
In all, 36 states have between one and six such dental programs.
When one program in the District of Columbia and another in the territory of Puerto Rico are included, there are 63 programs housed as “colleges” within medical schools or as “schools” within higher education institutions.
Dental programs in states neighboring Arkansas that can draw Arkansans away for study and training include two in Tennessee, one in Missouri, one in Oklahoma, three in Texas, and one each in Louisiana and Mississippi.
Roughly 70 percent of Arkansas dental students attend the two Tennessee schools, Cranford said, the University of Tennessee Health Science Center College of Dentistry in Memphis and Meharry Medical College School of Dentistry in Nashville.
Education officials have found over the years that it can be difficult to draw the dentists back to the state to practice, particularly in rural areas.
“Five of our counties don’t have dentists at all,” Cranford said.
Those counties are Calhoun, Cleveland, Lafayette, Perry and Newton.
“One of the main goals of a college would be improving the distribution of dentists in the state,” Cranford said.
Sixty percent of Arkansas’ practicing dentists are clustered within its eight most populous counties, though the eight are home to only 40 percent of the state’s people, he said.
“So you can see, many of the people who live in those counties think we’ve got plenty of dentists,” Cranford said.
Citing a 2009 report by the Arkansas Board of Dental Examiners, Cranford said there have been an average of only 32 newly licensed dentists in the state in each year of the preceding 10 years, 332 total in the decade.
“That doesn’t mean that all of those continued to practice here,” he said, and some dentists are licensed in more than one state.
Also in 2009, 1,331 dentists were licensed to practice in Arkansas, a figure that doesn’t show whether the dentists practice full time - or at all.
And as a recent national report warned, a wave of aging baby boomer-generation dentists are beginning to retire.
Nationally, the problem is both an overall shortage of dentists and an uneven distribution, according to the report submitted to the U.S. Senate during a Feb. 29 hearing by U.S. Sen. Bernie Sanders, I-Vt.
Sanders is chairman of the Senate Committee on Health, Education, Labor and Pensions’ subcommittee on primary health and aging.
His report found a need for nearly 9,500 new dental providers to meet the country’s current oral-health needs.
“There are more dentists retiring each year than there are dental-school graduates to replace them,” the study found.
About 190,000 dentists are practicing in the United States, the report said. “Not only is this number too low to meet the current need, but an uneven distribution of dentists across the country makes the problem even worse.”
Dentists have a disproportionate presence in the nation’s suburbs, while the low-income people who most need the care - particularly those who are hospitalized with chronic diseases complicated by severe oral-health problems or who go to emergency rooms after dental health is severely compromised - tend to live in the inner cities or in rural America,the report found.
“There’s a large student demand now,” Cranford said. “If we had our own school now, there’d be large numbers of applicants.”
Arkansas, Pages 7 on 03/19/2012