TAMPA — At a time when securing state funding is much like pulling teeth, three Florida universities want to start their own expensive dental programs.
The state has only one dental school — at the University of Florida in Gainesville — so officials at colleges in Orlando, Tallahassee and Boca Raton say there's plenty of room for them to get in on the action.
"For us, it's a good fit because not only are we responding to students' needs and requests, we're creating jobs," said Zenaida Kotala, a spokeswoman for the University of Central Florida.
But numbers tell a different story. The Board of Governors, which oversees the state's 11 public universities, heard reports last month that Florida is adequately stocked with dentists.
There are now more than 11,000 licensed dentists in Florida, ranking it fourth in the country. And that number will go up when the private Lake Erie College of Osteopathic Medicine in Bradenton opens its dental program next year.
The problem is where those dentists decide to practice, or rather, where they don't, according to the reports from the board's staff and the Department of Health.
About a third of Florida's dentists are concentrated in just two of the state's 67 counties: Miami-Dade and Broward, which are at the high end of the wage spectrum, according to Health Department findings.
It's a matter of economics.
Dentists, who graduate with more than $150,000 in debt from UF on average, often don't want to go where they can't make money. If residents can't pay for services, dentists try to scrape what they can from Medicaid reimbursements, which, according to the report, are the lowest in the country. Financially, it doesn't really make sense.
A Health Department committee came up with a list of solutions, including expanding community prevention services, increasing Medicaid rates, funding a loan-forgiveness program for dentists in underserved areas and strengthening the volunteer work force.
Out of 50 ideas, implementing new dental schools ranked 50th in feasibility.
"Discussions surrounding new or expanded dental schools should be based on a work force shortage that can be solved only by creating dental schools," said R.E. LeMon, the board's associate vice chancellor for academic and student affairs.
The president of the Florida Dental Association, Dr. Cesar Sabates, put out his own statement on the issue, saying, "Simply graduating more dentists with more student loan debt and hoping that additional dental schools can make up the difference in operating costs through low Medicaid reimbursement rates is a very convoluted and inefficient strategy for improving public access to dental care."
Dental schools are among the costliest on a university campus.
As part of its annual forward-looking work plan, UF told the board at its June meeting that it wants $2.8 million from the state to add 80 students to its dental school.
"What's happened in society, is there are a lot of unmet dental needs in our community," UF's dental college dean, Teresa Dolan, said later. "I think we do serve a purpose in meeting some of that need. The real question is, how many dentists do you need."
She added that UF would be happy to explore partnerships with other universities.
UCF wants to build a $42 million school with a $10 million anonymous donation and the rest with loans. It would be self-supporting and not rely on taxpayer dollars, Kotala said.
UCF has seen the Health Department findings, but, "We're a university," she said. "We can't change how Medicaid is done."
And UCF is convinced it can provide a service that's needed in the Orlando area.
"We would be able to address some of our local needs, specifically for people who can't afford dental care," Kotala said.
FAU, in Boca Raton, issued a blanket statement on its plan, saying, "Florida Atlantic University is in the early process of reviewing the studies reflecting the service needs in the field of dentistry throughout the rural counties in Florida. FAU looks forward to cooperating with a systemwide approach in order to meet the needs of the state of Florida."
And FAMU highlighted its intent to focus on "the oral health care needs of Florida's underserved, low-income, and rural communities," on the Tallahassee school's Web page devoted to the vision.
When the presentations wrapped up last month, the members of the Board of Governors looked around the table. There was no vote to be taken, no decision to be made.
At least, not yet.
Proposals could come as soon as the board's next meeting in September. But should the schools even bother?
State University System chancellor Frank Brogan said yes.
"Whether we need more dentists and how we go about getting there is something the board has to consider," Brogan told the other members. "But I think it makes sense based on where we all know we are in the process, that ideally we can have that kind of conversation and universities should be allowed to make those proposals."
Reach Kim Wilmath at firstname.lastname@example.org or 813-226-3337.