There was a heated debate last Thursday at a meeting of the State Building Commission regarding the need for more dentists and possibly also a new dental school in Wisconsin. The commission was considering a $10 million grant to Marshfield Clinic to set up a center to train rural dentists.

The current plan is not for a new dental school, but Marquette University, which now has the state’s only dental school, opposed the grant last week. Although they initially supported the legislation setting aside the funding, Marquette officials said they changed their mind after learning about Marshfield’s desire to eventually turn the program into a dental school. Despite the oppostion of Marquette and the Wisconsin Dental Association, the Commission voted 6 to 2 to approve the grant, which matches $10 million in private funds raised by Marshfield. Governor Doyle signed a bill last spring, at the tail end of the legislative session, authorizing the Commission to provide $10 million for the construction of a dental training center, if Marshfield could raise that much in matching funds within the next five years. It took far less time than that, when Security Health Plan of Wisconsin – which is a nonprofit health insurance company affiliated with the Marshfield Clinic – agreed to provide the needed match.

The center would help prospective dentists qualify for dental school by working with rural patients, and it would also offer residencies to dental school graduates. The goal is to recruit prospective dentists from rural areas and to encourage them to work in the underserved rural parts of the state.

The debate over the funding reflects some deep divisions regarding how Wisconsin should go about improving access to dental care for low-income state residents. An article by Guy Boulton in the Dec. 16 Milwaukee Journal Sentinel does a very nice job of describing the controversy and the need for improved access to dental care, particularly among Wisconsin residents on Medicaid and BadgerCare Plus (BC+).

Marquette’s positions are often aligned with those of the Wisconsin Dental Association, which argues that the state has enough dentists and should put its scarce fiscal resources into increasing Medicaid reimbursement rates for dental care, they argue would increase the number of private dentists willing to serve Medicaid and BC+ participants.

Marshfield contends that meeting the very substantial unmet needs of low-income Wisconsinites will require far more dentists, and those dentists need to be recruited and trained in ways that have been shown elsewhere to be effective in getting them to work in underserved communities. Marshfield has won over many policymakers to its point of view because it has been such a leader in opening new dental clinics and improving access to dental care in the northern half of the state.

A brief but very good May 2010 State Journal article by David Wahlberg summarizes Marshfield’s vision for a new dental school, as well as the arguments against it.

Jon Peacock