{ association insights } Executive Office Updates


OPA EFDA Pilot Project Update


by VICKI WILBERS, EXECUTIVE DIRECTOR “B


uild it and they will come” seems to be the mantra for this project. It’s appropri- ate for the work effort from


those participating in the Oral Preventive Assistant (OPA) Expanded Function Dental Assistant (EFDA) Pilot Project — dentists, trained OPAs, hygienists, front office admin- istrators and more — and for the other many dentists supporting this effort in multiple ways.


It’s been since last fall that a formal update was given on the OPA Pilot project — though each week we respond to emails from doc- tors asking us when the OPA will be available to help with the critical workforce need in their offices, which impacts patient care. The purpose of the article is to refresh you with an outline of the project, give a status update and, most critically, request your continued support.


REVIEWING THE WORKFORCE ISSUE


Since 2023 when we first began to address workforce issues, not much has statistically changed in the shortage of the oral health- care workforce. Like all healthcare sectors, the oral healthcare workforce is critically shorthanded and the period affected by COVID exacerbated the issue. In a 2023 report, the Missouri Office of Dental Health (ODH) indicated that approximately 10 per- cent of the oral healthcare workforce exited healthcare during COVID. A survey by ODH also revealed that 20 percent of the work- force were considering retirement in the next five years due to age or job stress.


The result is significantly understaffed clinics operating at 60 to 80 percent of capacity.


12 focus | FALL 2025 | ISSUE 3


Workforce shortages have had a more severe impact on rural clinics and those serving the eligible Medicaid population, with appoint- ment wait times in many Federally Qualified Health Centers and clinics serving Medicaid patients lasting weeks or even months. The ODH used license and permit data to deter- mine provider locations and identify areas where more providers are needed.


When you look at these maps (with all coun- ties not colored in blue considered shortage areas), you can note the following:


• All but a few metropolitan counties have significant oral healthcare workforce shortages. Rural areas are the most severely impacted.


• There is a shortage of dentists and dental hygienists in rural Missouri: 44 percent of clinics that had an opening for a dental hygienist were unable to fill that opening.


• You will see that EFDAs are distributed more evenly throughout the state, espe- cially in rural areas where hygienists are scarce. The relative scarcity of hygienists in rural areas hasn’t changed signifi- cantly since 1990, despite nearly 2,200 additional hygienists being licensed and residing in Missouri. The training centers are in metropolitan areas, and most graduates find employment within a 50-mile radius of the school they at- tended. In fact, when comparing 2022 maps with 2023 maps, EFDA distribu- tion was the only category showing im- provement, in that three fewer counties were among shortage areas, whereas an additional county for RDH was added to the designation for shortage areas.


DENTIST SHORTAGE AREAS


RDH SHORTAGE AREAS


EFDA SHORTAGE AREAS


Missouri Dental Workforce Distribution Maps,


provided by the Missouri Office of Dental Health. For all maps, all counties not colored in blue are considered shortage areas. These are the most recent maps, dated January 19, 2023.


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