Delta Dental of Colorado Foundation, one of the largest funders of oral health initiatives in the state, on Monday said it’s granting a total of nearly $5 million to four colleges to help them expand existing dental hygiene programs or start new ones from scratch — all with the goal of addressing workforce shortages and diversifying the profession.
The grants, split among Front Range Community College, Community College of Denver, Colorado Mountain College and Pikes Peak State College, will be distributed in installments over the next four years. The colleges were selected in part because of their diverse student populations, said Adeeb Khan, executive director of Delta Dental of Colorado Foundation.
The grants will help establish dental hygiene programs at Front Range Community College, Colorado Mountain College and Pikes Peak State College by 2025 and will expand the number of seats available to students in an existing dental hygiene program at Community College of Denver starting this fall.
The three public colleges that currently offer dental hygiene programs in the state have a total of 75 seats for students who want to become dental hygienists. The new grants aim to double the state’s capacity to train dental hygienists in programs that usually last two to three years.
“Two years ago, we made a fundamental decision to deepen our commitment to oral health equity by investing with an expectation of long-term outcomes,” Khan said. “The investments we’re celebrating today will ensure that Colorado has the ability to address oral health care workforce shortages by expanding our capacity to train dental hygienists and also providing more pathways for diverse populations.”
Delta Dental of Colorado Foundation leaders announced the grants at a time when the number of dental hygienists continues to dwindle and the industry struggles to meet the needs of Colorado’s growing population. Coloradans won’t see a drastic change in the number of dental hygienists for a few years, but Delta Dental leaders said the grants are essential to eventually closing the gap.
The grants are offered to schools that already have a commitment to diversifying their student population. Attracting, educating and retaining dental hygienists who are people of color, and those who speak multiple languages, for example, can help achieve racial balance between dental providers and their patients, increase access to care and create oral health equity.
On Monday afternoon, higher education officials gathered with Gov. Jared Polis, at a Denver coworking space for health care professionals to announce the distribution of the grants.
At the event, Polis said, the dental industry is not the only profession navigating a workforce shortage in Colorado. Last year, the state created The Care Forward Colorado Program to address shortages in health care jobs. The program provides a free education to students interested in becoming certified nursing assistants, emergency medical technicians, pharmacy technicians, phlebotomy technicians, medical assistants or dental assistants, he said.
Since the program was implemented, more than 1,400 Coloradans have gone through the program, and there has been a 20% to 30% increase in the number of people seeking certification to work in those professions, Polis said.
Now, with the new grants from Delta Dental of Colorado Foundation, many more students will have the opportunity to train for careers in dental hygiene to help fill the gaps the state has, said Polis, who has made addressing workforce shortages part of his gubernatorial agenda.
The number of dental hygiene positions needed will grow by 35% by the end of this year with about 650 openings remaining every year, said Joe Garcia, chancellor of the Colorado community college system, who spoke at Monday’s event.
About 95% of students who attend community colleges in Colorado remain in the state after they graduate, he said. And nearly half of all students of color involved in higher education are also educated in Colorado’s community colleges, he said.
“These are often the students who have been overlooked or who haven’t been able to access higher education opportunities in Colorado, and yet, they are the fastest growing demographic in our state,” he said. “We’ve got to start to serve them and we’ve got to rely on them because they’re going to serve us. We cannot meet our workforce needs or gaps without doing a better job of educating underrepresented populations.”
Since September 2020, employment of dental hygienists has steadily declined and may continue to dwindle without swift and immediate interventions, according to the American Dental Hygienists’ Association and the American Dental Association’s Health Policy Institute.
A March 2022 poll by the Health Policy Institute found almost 34% of dental practices were actively recruiting dental hygienists. More than 80% of dental practices that responded to the poll said it was “extremely challenging” or “very challenging” to recruit dental hygienists.
Delta Dental Foundation leaders offered funding to schools that are able to continue fundraising to handle any remaining costs associated with expanding or starting new dental hygiene programs.
Why educating people now matters
Projections show that by 2045, people of color will make up the majority of the U.S. population for the first time. And as demographics of the U.S. population continue to shift, a diverse and culturally competent workforce will become more crucial than ever.
Research shows patients are more trusting of health care providers who share their race or ethnicity. But the demographics of the dental workforce don’t match the makeup of the U.S. population. A 2020 Health Policy Institute poll showed less than 10% of dentists were Black, Hispanic or Latino in 2020, while those groups made up more than 30% of the U.S. population, according to the Health Policy Institute.
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In Colorado in 2019, 81% of Black people had insurance, meaning they collectively had more coverage than any other racial group in the state. However, only 56% of Black Coloradans visited a dental professional that year, meaning they were the least likely to visit a dentist when compared with all other racial groups, according to the 2019 Colorado Health Access Survey.
The data highlights a disconnect that needs to be resolved, and a lack of diversity in the workforce is a significant part of the problem that should be swiftly addressed, Delta Dental leaders said.
For example, Black dentists are about twice as likely to accept Medicaid compared with white dentists, according to the Health Policy Institute poll. If the profession remains overwhelmingly white, patients with Medicaid will continue struggling to access oral health care, as they have for decades.
Creating more dental hygiene programs in Colorado that include a more diverse student population will increase access to oral health care and could reduce oral health inequities that have persisted for many Coloradans of color and for people living in rural and urban parts of the state, Delta Dental leaders said.
The expansion of the programs is especially vital, more than two years after the COVID-19 pandemic shut down the oral health care system for 10 or 11 weeks in Colorado, which was followed by apprehension and fear about visiting dental offices among patients and providers, a trend that caused some hygienists to leave the profession altogether or retire early, Khan said.
Now, with the new grants, the dental profession has another chance at reviving the dental hygiene industry. The Colorado schools selected to receive grants got their first payments in November, Khan said, and will receive another installment sometime this week.
Lance Bolton, president of Pikes Peak State College, said the funding will help school leaders develop a new dental hygiene program that will open in fall of 2025. The number of students accepted will depend on formulas determined during the upcoming accreditation process and the number of faculty available to teach. The new program will most likely be able to accommodate 30 students, he said.
“We don’t have a dental hygiene program,” he said. “Starting one is incredibly expensive. It requires us to hire a faculty member for approximately two years before we even enroll our first student to build the curriculum, get the program accredited and get ready to start. It also requires a very significant investment in dental equipment. So the Delta Dental gift absolutely catalyzed the initiation of this program. We wouldn’t be here without that.”
Pikes Peak State College leaders plan to develop curriculum based on existing dental hygiene programs at other Colorado colleges, Bolton said. Thirty percent of the seats in the dental hygiene program will be reserved for students graduating from the school’s dental assistant program, where about 75% of students are minorities, he said. That strategy will help train students who are underrepresented in the dental industry and hopefully encourage them to work in Colorado, he said.
There is no dental hygiene program offered in the Pikes Peak region, he said, meaning local dentists are having a difficult time filling those positions.
Paola Hernandez, a second-year student at Pikes Peak State College, from a young age had dreams of becoming a dental hygienist. But she’s currently studying to become a dental assistant because there aren’t any dental hygiene programs near her home in Colorado Springs. The closest schools offering dental hygiene programs are in Pueblo or Denver, too far away for Hernandez to consider.
The new grant will make it possible for her to come back to Pikes Peak State College to study dental hygiene after she graduates in May 2024 and spends at least a year working as a dental assistant. “That has always been my number one plan and the first thing that I wanted to do.”
Dental care is not routine in Durango, Mexico, where Hernandez was born. Her parents, who speak mostly Spanish, often struggle in Colorado to communicate with dentists and hygienists about where they’re feeling pain in their mouth. Sometimes her parents have to return to the dentist because the pain wasn’t resolved. Hernandez said she sometimes attends those appointments to help interpret.
“Being able to communicate with your patients is what I want to be able to give,” she said.
The most important part about becoming a dental hygienist is gaining the skills needed to help people feel confident and dignified when they smile, she said at the event on Monday.
When visiting a dental clinic, most people expect to have their teeth examined by a dentist. However, patients often spend the most time at a clinic under the care of a dental assistant or a dental hygienist. Dental hygienists provide regular cleanings, offer fluoride and sealants, perform screenings and give patients tips for effective oral health care at home while dental assistants help dentists during treatments, ask about the patient’s medical history, take client’s blood pressure and pulse, sterilize equipment and help people feel comfortable before, during and after treatment, according to the American Dental Association.
Licensed dental hygienists have the opportunity to earn a good wage. Their median annual wage was $81,400, according to May 2022 U.S. Bureau of Labor Statistics, and those earnings increase as these professionals advance in their careers. Some dental hygienists who work on a contract basis have more flexibility in their work, and in Colorado, a dental hygienist can open their own practice, Khan said.
Who will teach in these programs?
One of the challenges many colleges face is finding people qualified to teach dental hygiene classes and train hygienists.
Now, Delta Dental is raising awareness about the new and expanding dental hygiene programs in communities across the state where the organization is already working to advance oral health equity through other initiatives.
It’s too hard to say if more funds will be needed to help colleges add or expand dental hygiene programs, by the time the grants run out, or if workforce shortages will be addressed, Khan said.
Colorado does not contribute as much funding to higher education when compared to other states and there may be other opportunities for the state to make monetary contributions to the dental hygiene effort in the future, he said. For example, in Oregon, a proposed bill would provide $20 million for recruiting and retaining dental workers, and to support and create training programs.
“This funding in and of itself is not enough for what the schools are going to need to be able to really execute on these programs, so they still have additional fundraising requirements to be able to fully execute on some of their plans,” Khan said of the foundation’s grants.
As the program progresses, schools will report to Delta Dental on progress made about how well it’s attracting and retaining hygienists from underrepresented groups and other data to show enough students are graduating to help close the workforce shortage.
“It’s a long runway, but at the end of the day, this is the solution we need,” Khan said.