VIRGINIA GENERAL ASSEMBLY

Strengthen Virginia’s Preventative Dental Workforce and Expand Access to Care:

Deliver • Develop • Deploy

Problem

Virginians Can’t Wait for Dental Care

Virginia is facing a critical shortage of dental hygienists and skilled providers across the Commonwealth, but especially in rural and underserved areas, resulting in long waits for routine care that prevents dental disease.

Dental hygienists provide essential preventative care, and Virginia does not license enough hygienists to meet current patient, employer, and student demand.

Dentists can supervise up to four hygienists in Virginia, but we have 1,500 more full-time-equivalent dentists than hygienists today in the Commonwealth.

Virginia has one of the highest concentrations of dentists and the lowest concentrations of dental hygienists in the country.

There are seven applicants for every available seat in a dental hygiene program.

Virginians are waiting months for appointments—or worse, going without care.

Without urgent and incremental action, this shortage will continue to jeopardize preventive care, early diagnosis, and the overall health of our communities.

Background

Annual licensure surveys from the Virginia Department of Health have laid out clear trends for Virginia’s dental workforce needs and the bottleneck of education programs that prevent dental professionals from advancing their ability to provide preventative dental hygiene services.

There are regional variances, but Virginia has one of the highest concentrations of general dentists in the country, and one of the lowest concentrations of dental hygienists. It is not due to a lack of interest, as every dental hygiene education program in the state has an extensive wait list, turning away qualified dental assistant applicants who want to provide preventive dental care to their patients.

21 community colleges in Virginia offer nursing programs, and only six are currently enrolling dental hygienists following the recent indefinite pause in admissions at Virginia Peninsula Community College.

HRSA projects Virginia is more than 1,000 hygienists short of where we need to be, and particularly in Greater Richmond and Northern Virginia, has an imbalance of dentists and hygienists that leaves long patient waits for care, too many dentists taking on duties that were previously assigned to other team members, and burnout in the dental team.

VDA Activity

The VDA has been working with partners and public and private schools to address the bottleneck for students. In the last few years, VCU and ODU have increased enrollment in their programs, and FORTIS College in Richmond has applied to CODA to establish a 30-month program with the goal of 30 additional annual dental hygiene graduates a year.

The VDA and partners have had substantive meetings with three additional community colleges to help fill the gap in the funding barriers that are keeping them from sustaining, in the case of Virginia Peninsula, or in the case of Mountain Empire and Piedmont Virginia Community Colleges, establishing programs.

These are all important steps to meeting the long-term needs of our member dentists and their patients – and they will require funding to move forward. But if we rely on those measures alone, millions of Virginians will unnecessarily go without access to essential preventative dental care in the coming years.

With that in mind, the VDA’s House of Delegates met in January of this year and charged the VDA with pursuing options to increase pathways to the dental workforce, including an expedited pathway for internationally educated dentists to practice dental hygiene and allowing a pathway for experienced dental assistants to provide additional services in support of hygienists.

The VDA has held extensive meetings with other states with existing laws in this vein, and surveyed our members this spring to solicit additional feedback on the parameters they would support.

More than 80 percent of our member dentists indicated they would consider hiring a qualified internationally educated dentist who went through an expedited pathway to provide hygiene services, and an appropriately trained dental assistant to provide limited scaling above the gumline on periodontally healthy patients.

Senator Todd Pillion sponsored successful VDA-supported legislation this year that directed the Board of Dentistry to hold a work group to further look into parameters around an expedited pathway to licensure for internationally educated dentists. While the work group, which included the Virginia Dental Hygienists’ Association, did not make a unified recommendation, it helped clarify certain criteria, including the passage of a national exam, that a pathway would allow the Board of Dentistry to evaluate credentials and MAY, not SHALL, grant licensure to those who meet the criteria laid out in the legislation.

The VDA Board of Directors and Council on Government Affairs have spent extensive time with the input of VDA members and legislators to develop these important workforce proposals. The VDA also sent a letter to the Virginia Dental Hygienists’ Association this summer, inviting them to share any ideas they had around addressing workforce needs, and they have not yet received a response. The American Dental Hygienists’ Association affirmed its intent earlier this year to establish the baccalaureate degree as the minimum entry level for dental hygiene practice, which would cut off the most commonly used pathway for hygienist education in Virginia.

Solution

The Virginia Dental Association (VDA) proposes a strategic legislative initiative to Deliver, Develop, and Deploy resources where they’re needed most:

Deliver Skilled International Providers to Provide Preventative Dental Care

Virginia can benefit from the talents of internationally educated dentists already living in our communities. Let’s remove outdated barriers and create a pathway to licensure for preventative care that upholds standards while tapping into this underused workforce. The legislation gives discretion to the Board of Dentistry to review credentials and includes completing examinations currently completed by hygienists.

Develop the Role of Dental Assistants

Dental Assistants already have a pathway to train in expanded functions, otherwise limited to other members of the dental team, to help alleviate workforce shortages. Virginia’s key shortage today is in dental hygienists, and appropriately educated dental assistants can be permitted to provide support to a hygienist workforce experiencing critical shortages. Virginia can allow reciprocity for military preventative assistants by allowing those who meet federal requirements for limited scaling and polishing to do so.

Deploy Budget Support to Alleviate the Education Bottleneck for Hygienists

We must invest to increase the number of seats available in dental hygiene education programs, which have comparatively high operating costs but provide a pathway to the highest-paying healthcare role available with a two-year college degree. With the right funding and incentives, we can fill vacancies faster, particularly in underserved regions.

These initiatives are collectively an evidence-based workforce solution that meets the moment. With your support, we can make sure no Virginian is left waiting for a healthier smile.

Take Action

The VDA will be holding additional Town Hall meetings with members in the weeks ahead, and we encourage all VDA member dentists to participate.