Here in Milwaukee and in other urban spots statewide and nationwide, they’re easy to find. You can’t go a few blocks without running into a dental office or dental associates or dental whatever-they-call-themselves.
But that’s not the case in most of the state.
The federal government has designated more than half of Wisconsin’s counties as “Health Professional Shortage Areas” — i.e. they don’t have enough doctors or dentists.
Elected officials representing rural areas and advocates are quick to rattle off horror stories of Wisconsinites having to drive hours to get to dentists’ offices after monthslong waits for an appointment with an overworked dentist.
Besides the pain and health risks, diseased teeth can also become “an oral health barrier to work,” says Greg Nycz, the director of the Marshfield Clinic; it’s much tougher to get a service industry job if your mouth-bones appear rotten, for example.
Providing more access to dentists, some Wisconsin legislators think, could fix all that.
First comes the hurdle of actually finding dentists to do the job.
Millennials prefer urban living, at an even higher percentage than Baby Boomers and GenXers did when they were the same age. Young dentists are no different.
There are dental students who could be interested in working outside of cities, but they are often skittish about taking jobs away from their friends. Not to mention, although cost of living is cheaper in rural areas, salaries tend to be down too. That matters a lot when you’ve just finished seven-plus of college and are, in all likelihood, loaded with debt.
“We have to fix that situation,” Rep. Debra Kolste (D-Janesville) said of student debt, for both dentists and typical collegians, during an Assembly Committee on Health meeting in October.
There’s a proposal going through the state legislature that would incentivize dentists to practice in rural areas immediately after graduation, saving those students money while also combatting Wisconsin’s tooth-doctor distribution problem.
One such student who could end up making a difference is Bailey Miller. He’s a senior at St. Norbert College and plans to attend the Marquette School of Dentistry, the only dentistry school in Wisconsin. About 90 new dentists graduate from the school yearly.
Getting your DDS ain’t cheap. Tuition alone at Marquette School of Dentistry, which has a three-year dental program, is around $60,000 per year. And last summer, Miller told the Assembly Committee on Health in August that he’s already $30,000 in debt. Once he starts dental school, that number is only going to go up.
The solution to the dentist distribution problem, as proposed by a handful of state representative and senators, is to create state-funded scholarships to Marquette students. These scholarships would only be provided to students who promise to work in Health Professional Shortage Areas post-grad.
“They (young dentists) are going to see the benefit and the value and quality of life in small-town Wisconsin,” says Sen. Patrick Testin (R-Stevens Point), one of the bill’s authors. “Our hope is that they will stay there.”
The proposal is known as “Bailey’s Bill,” named after the afore-mentioned Bailey Miller.
Miller is from Reedsberg, a community of fewer than 10,000 southwest of the Wisconsin Dells; Miller’s parents still live on a farm there.
As a kid, Miller was one of the few who enjoyed trips to the dentist. After shadowing his childhood family dentist, “I fell in love immediately” with the occupation.
He would love to work in a place like where he grew up. But without the incentive, that’d be a tough sell financially.
Miller remembered his mother telling him: “Your debt, when you’re done (with dental school), it’s going to be hard to make up once you go rural. It’s going to take a lot more time.”
But, he continued, “I myself would love return closer to home … I want to go home, work rural.”
Gov. Tony Evers, in one of his 78 budget vetoes issued last July, blocked $800,000 that had been designated for the scholarships; Evers didn’t like the idea of devoting money to helping just parts of the state, even though the problem of not enough dentists is specifically a rural issue.
“There’s $800,000 just sitting there,” says a Testin staffer.
Evers’ veto is the reason why the proposal is going through the legislature the old-fashioned way now.
The bill finally got through the committee at the end of October, three months after Evers’ veto. Then, last week, it passed the Assembly with massive bipartisan support: a 95-2 vote.
The Senate (and, likely eventually, the governor) will decide the scholarships’ fate.
Although the government is paying attention now, Dr. Jeff Matthews, a veteran dentist based in Whitehall, doesn’t think the federally defined shortage is all that new.
“If new dental students are actually looking for jobs in rural areas,” he says, “I think they (the jobs) are going to be available. They’ve always been available.”