Dentists debate need for school at UNLV

Jerry Fink and Art Nadler

Monday, June 8, 1998 | 10:21 a.m.

A proposed dental school at UNLV is causing mixed concerns within the dental community.

Sen. Raymond Rawson, R-Las Vegas, himself a dentist for 30 years, sees a dental school as a godsend for two groups in Clark County -- children and senior citizens.

"We have 140,000 children who are uninsured, and we know they are not being seen by anyone," Rawson said. "They have to pay cash up front."

The dental school could be a free resource for most of these indigent children. It could also be a source for certain difficult surgical procedures, such as cranial facial treatments, Rawson said.

"The young dentists may resent it because they see it as competition," the senator said. "But I think the growth is the biggest thing (causing a need for a school.)"

UNLV President Carol Harter said, "There has never been a dental school in Nevada. Up till now, Nevada citizens did not have an option for a public dental education.

"They must pay out of state or private school tuition to go to dental school, and very few of those who go out of state come back to practice. We are not getting them back, which is a very good argument for consideration of a dental school in Nevada."

With Southern Nevada's growing senior population, the school would be a huge help, said Ed Fend, a lobbyist with the American Association of Retired Persons (AARP).

Currently, there are 194,000 AARP members in Nevada. He estimates that 75 percent of these people live in Southern Nevada.

Medicare -- even with a supplemental policy -- doesn't cover dental, Fend said. Seniors either have to buy their own managed-care policy, or pay for costs out of pocket.

"A dental school would be a very big plus for Nevada's elderly population," Fend said.

But some dentists like Dr. Robin Lobato think a dental school is not needed and wouldn't be supported by the state.

"In order to bring in a school, that will cost a lot of money," said Lobato, a Las Vegas native. "We do have the growth, but schools are closing. Georgetown closed, and Northwestern will be closing."

Lobato sees Nevada's tough dental board exams as limiting the number of dentists opening practices. It cost him $3,000 for the four-day examination, where he had to fly in his own patients and perform difficult procedures that practicing dentists would take weeks to complete.

"I think the exams should be like this," Lobato said in defense of the board. "But being tough is one of the limiting (shortage) factors."

While Nevada's lack of fluoride in its water supply also may be a small factor in the state's high dental need, Lobato wasn't sure how important a role it played.

According to the Centers for Disease Control and Prevention, only 2.1 percent of the population in Nevada in 1992 used some source of fluoridated water. It cites studies showing that fluoride in the water reduces tooth decay by approximately 17 to 40 percent.

The dental school would be one of several new program additions the university wants to offer in allied health, Harter said.

"There is a whole array of possible new programs, proposals that have been made in our academic master plan," she said.

Among them are nutrition, physical therapy, occupational therapy and pediatrics.

Nevada has one of the lowest ratios of dentists in the country, which proponents say highlights the need for the state's first school of dentistry.

According to a study commissioned by UNLV and released in April, the state has 4.27 dentists per 10,000 residents while the national average is 6.13.

The American Dental Association, in a 1995 study, said Nevada has approximately 570 dentists compared to more than 20,000 in California.

That reflects a ratio of about one dentist for every 2,680 Nevadans and one for every 1,575 Californians.

Consultant Linda DuBois, associate dean of academic affairs at Northwestern University Dental School and author of the more recent study, says Nevada's ratio is 46th in the nation.

According to her conclusion, the state's need for dentists is increasing -- corresponding with its population growth -- at a time when there is a decreasing number of dentists nationwide.

"The projected number of new openings for dentists in Nevada is 40 per year," said DuBois. "This statistic is based on the need for replacement workers and the creation of new jobs."

DuBois claims the state has the largest percentage of citizens who are under-served by dentists.

A dental school at UNLV would go a long way toward correcting that glaring imbalance, according to supporters of the proposed facility that still must be approved by the 1999 Legislature before the first shovel of dirt is turned.

At its regular meeting earlier this month, regents of the University and Community College System of Nevada voted to ask the state for construction funds.

DuBois estimated cost of the building is $15.4 million and the cost of equipment $1 million. The annual operation cost would be about $5.3 million.

Harter said those estimates are "ball park figures" used by DuBois to give a "generic idea" about the cost.

"Those numbers are not final," said Harter.

There are 55 dental schools in the country with an enrollment of more than 16,570 students, according to American Dental Association spokeswoman Jann Ingmire, and there are more than 153,000 practicing dentists in the nation.

Dennis Brandstetter, chairman of the Counsel on Dental Education and a practicing dentist in Minnesota, said the counsel and the ADA takes no position on whether a dental school is needed in any particular area.

"Market forces determine the need for the dental school," he said.

Since 1982, the number of graduates from American dental schools has declined by about one-third, said DuBois, citing ADA statistics.

Also declining is the number of dentists per population, according to the Bureau of Health Professions.

DuBois' study cited a number of benefits that would be enjoyed by creation of a local dental school, aside from the obvious benefit of providing a place for educating dentists who might tend to stay in the state.

The school would attract faculty with outstanding clinical credentials, who would have the expertise to treat unusually difficult cases that would be referred to the college from community dentists, the study says.

Creation of the 56th dental college in the nation would enhance UNLV's reputation, helping it to "join these prestigious universities."

Over the next year, UNLV will prepare a planning document for the College of Dental Science and present it to the regents, who will forward it to the Legislature in time for the session beginning in March 1999.

If there are no delays, the building will be completed in time for the first class in the fall of 2001.

The plans call for 40 students in the first class and eventually a total enrollment of 160.