Tooth in Advertising: program attracts dentists to Range

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I’ve got decent insurance now, so my three kids could go to the dentist starting at an early age. That wasn’t the case for my parents. But when it came time for my boys to go to the dentist, we still had a hard time getting them in. My lifelong dentist wasn’t accepting new patients, no matter the fact that three generations of my family had gone to him.

Access to dental care represents one of the great divides in this country. One part is cost. Some people can afford it or have dental plans through work. Many others cannot. But another part is simple math: fewer dentists work in rural areas. My dentist, now retired, was one of many Range dentists barely able to serve a massive patient load.

These problems taken together demonstrate why going to the dentist here in Northern Minnesota isn’t as easy as elsewhere. This becomes especially true for those new to the area or low income.

An estabished program funded by the IRRRB and the state Martha Mordini Rukavina Loan Forgiveness Program forgives student loans for new dentists who practice in the Taconite Tax Relief Area, the legal political definition of the Iron Range. Dentists commit to working here for at least five years and in return receive up to $120,000 in loan forgiveness.

Manja Holter of Business North reports:

There is a well-documented shortage of dentists who will practice general dentistry full-time on the Iron Range. Statewide, the overall rate of dentists – 55 per 100,000 people – is almost in line with the national rate of 61 dentists per 100,000. In isolated and rural areas, however, that average sinks dramatically to 26 dentist per 100,000 people, making it hard to find a dental provider regardless of what type of insurance coverage one has.

“The problem is going to get much worse because numbers from the Minnesota Department of Health indicate that within the next 10 years, 50 percent of the presently practicing dentists in Minnesota will be retired,” said Dr. Michael Zakula, a director on the Minnesota Dental Foundation Board of Directors and past president of the Minnesota Dental Association.

Student debt most palpably deters dental school graduates from pursuing a career in rural northern Minnesota. It takes approximately five years to earn a degree in dental medicine and to complete residency. Tuition, living expenses and costs for instruments and books can rack up to anywhere from $150,000 to $300,000.

“With an average debt of $262,000, students look at a loan payment of $3,300 a month. That is what’s pushing a lot of young dentists into metropolitan, corporate-type practices,” stated Zakula.

The Iron Range program is now in full swing after being piloted nine years ago. It’s too early to see how many dentists stayed in the area after the program date. Zakula seems confident that many do.



  1. Gerald S says

    This is much more dismal for the large number of people on the Range and elsewhere in Northeast MN who are on Medical Assistance, where the payment rates for dentistry are far below standard rates, causing most dentists to severely restrict the numbers of MA patients they see. The patients end up dependent on periodic special “clinics” and on dentists who do make a special effort to reserve time for these patients. My own dentist spends half of every Friday seeing children who are on MA, but he is planning on retiring within the next year or so also.

    Seniors also have special issues with dental care, since Medicare and most Medicare supplemental insurance does not cover dental care, forcing them to pay out of pocket, often from severely reduced incomes.

    Dentistry has become much more profitable on a national basis lately, but a large amount of the profits come from elective cosmetic procedures and expensive reconstructive procedures. The market for those services is much better in larger cities and much better yet in other parts of the country, causing a lot of dentists to leave. The impact of $120,000 in forgiveness for $262,000 in loans is a lot less of a factor when compared with incomes averaging as much as two to three times as much in other places.

    As in medical care in general, in the long run the best pool of recruits for dentists in the Northland are people who grew up here and have memories and families drawing them home. Unfortunately, there just are not enough of them. The solution to this problem is improving education to create an increased supply of potential dental students and expanding the number of positions in dental school to help deal with local needs, possibly coupled with a service requirement to spend time working in areas with dental shortages after graduation.

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