DES MOINES - There aren't enough dentists in Iowa.

In fact, Black Hawk County is one of 55 Iowa counties designated as a dentist-shortage area. The county has six dentists under 35 years old and only 14 under 60, said Suzanne Heckenlaible, director of community and government relations for Delta Dental of Iowa, a nonprofit dental health services provider.

"Over the last decade, we've been losing dentists and have not been able to replace them, especially in rural areas in the state," Heckenlaible said.

In response, the Iowa Rural Dental Health Initiative this month unveiled a project called Fulfilling Iowa's Need for Dentists to enhance the Delta Dental of Iowa loan repayment program that helps dentists with their dental education debt.

Project organizers say they hope to stimulate community matching funds for the program, promote the importance of a dentist to the community's economic growth and overall health in identified rural communities, and administer the expanded program.

The initiative is funded by a U.S. Department of Health and Human Services grant, Delta Dental of Iowa and state matching grants. There will be three community matching loan repayment recipients through the FIND project over the next 12 months, Heckenlaible said.

Butler, Tama and Benton counties are classified as dentist-shortage areas in addition to Black Hawk County.

Reasons for shortage

The shortage is the product of a variety of factors, Heckenlaible said.

"The average age of a dentist today is 55 in Iowa," she said. "I think you'll see there's problems across the nation, especially in rural states. We're finding the ability to find, attract, and keep dentists to rural communities is becoming harder and harder."

The project is working to educate communities about the importance and impact of a dentist in that community and assist it in recruiting dentists and developing a long-term relationship with that community, Heckenlaible noted.

According to the University of Iowa, there is one dentist per 2,100 people in Black Hawk County, compared to 1 per 1,500 in Dubuque, 1 per 1,900 in Fort Dodge and 1 per 2,200 statewide. The ratio in Butler County is 1 per 7,000.

"In the counties around Waterloo and Cedar Falls, one dentist can make a lot of difference," said David Johnsen, dean of the University of Iowa's College of Dentistry.

"How far should people drive to get to a dentist?" Johnsen said.

Insurance factors also play a role. Dental care is delivered almost entirely by the private sector. It is not part of Medicare, and only about 1 percent is paid for by Medicaid, he said.

The University of Iowa is the predominant training ground for Iowa dentists, and the program is working with communities to expand the pool of available students, Johnsen said.

Roughly 80 percent of Iowa's dentists are U of I graduates. So retaining dentists is crucial.

The university's dental school has attracted a lot of students from out of state. Most leave Iowa after they graduate, Johnsen said. So the university has stepped up efforts to expand its pool of students from Iowa.

The number of dental students who attended an Iowa high school has climbed from less than 85 percent to more than 90 percent, Johnsen said.

The college is also working to recruit students from small communities across Iowa who hopefully will return to their hometowns after they obtain their licenses.

"We're finding we have a better chance of succeeding if the town kept in touch with the student from the time they left high school and went off to college," he said.

The program is relatively new, Johnsen said.

"The first class to graduate under our new policies as 2002, so we haven't had a long time to see how this works," he said. "Dental school is four years, so it takes time."

The Iowa Rural Dental Health Initiative's FIND partners include Delta Dental of Iowa, the Iowa Area Development Group, Ripple Effect, University of Northern Iowa Institute of Decision Making, Iowa Department of Public Health Oral Health Bureau and the University of Iowa College of Dentistry. The partnership received federal funds to be used over a one-year period starting Sept. 1.

Contact Jim Offner

at (319) 291-1598 or

jim.offner@wcfcourier.com.