Licensure and the dental market

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Virginia Tech

The dental profession in the United States has a history of organized activity designed to secure a market protected from outsiders. The development of this phenomenon follows a course that has paralleled that of the other licensed professions. The ultimate capture of the official blessings of the state by the argument of professional competency in the name of the public interest placed the profession in firm control of the dental market. The gatekeepers are dentists who control the market with the authority of the state police powers via the licensure process. These boards have executive, legislative and judicial authority granted by state legislatures in order to protect the interests of the public's dental health. However, the inflation rate of dental fees above the general inflation rate over the past several years suggests that the market has not been behaving in a competitive fashion. The decline in the incidence of dental caries coupled with an oversupply of dentists caused by the Congressional intervention of the 1960s and early 70s, has caused a financial crunch for the private practitioner. Meanwhile, emergent technology has created a market outside of the traditional political hierarchy, that threatens the authoritative structure of the profession. The processes of a simultaneous scientific and economic revolution poses an enormous threat to the status quo. The conflict has been drawn to the public forum of the state dental boards. Unfortunately, the government's goal of affordable, quality dental care for its citizens had been supplanted by "turf" battles, restricted market access and manpower mobility. The state dental boards have lost sight of their mission; to protect the public interest in the marketplace.