by Hannah Maxey | Feb 25, 2026 | Other
Featured Image: Bowen Center for Health Workforce Research and Policy Director Dr. Hannah Maxey providing dental care to a child in 2002.
February is a big month for teeth, all kinds of teeth! As we celebrate both National Children’s Dental Health Month and National Pet Dental Health Month, I find myself reflecting on my journey from dental hygienist to health workforce researcher, and why oral health still holds a special place in my heart (and my professional focus).
For nearly a decade, I practiced dental hygiene in public health clinics in Marion County, Indiana. I scaled tartar, taught proper brushing techniques to wiggly kindergarteners, and yes, occasionally dodged flying spit. It was hands-on, meaningful work that shaped how I think about healthcare access today. Those clinical years taught me something fundamental: Oral health isn’t separate from overall health. It’s the gateway.
Fast forward to today. I lead the Bowen Center for Health Workforce Research and Policy. I’ve traded my scalers for spreadsheets, but the mission hasn’t changed. Whether we’re talking about children who need preventive care or pets whose owners finally notice that doggy breath isn’t normal, access depends on having the right professionals in the right places.
Here’s what keeps me engaged: The workforce challenges are strikingly similar across the board. Pediatric dentists? There aren’t enough, especially in rural areas. Veterinary dentists? Even rarer. Dental hygienists who can practice in schools or community settings? Still fighting scope-of-practice in many states. The problems I witnessed as a practicing hygienist are the same ones I’m researching now, just with better data and hopefully more impact on policy.
Children’s oral health is particularly close to my heart. Dental disease remains the most common chronic childhood condition, yet it’s almost entirely preventable. When kids can’t access care because there aren’t enough providers or dental professionals can’t practice to the full extent of their training, that’s a workforce problem with real health consequences.
And our pets? They deserve better, too. Veterinary dental disease affects an estimated 80% of dogs and 70% of cats by age three, yet many pet owners don’t realize dental care is essential preventive medicine. The veterinary workforce faces similar shortages and geographic maldistribution as human healthcare.
This February, as I celebrate both these dental health months, I’m reminded why I loved clinical practice and why I’m passionate about workforce policy. The work I do now (tracking provider shortages, analyzing scope-of-practice regulations, informing policy decisions) all connects back to those days in the clinic, to the patients (both two-legged and four-legged) who need care, and to the dedicated professionals trying to provide it.
Some roots run deep. Mine just happen to start with health teeth and extend to caring about them in humans and animals alike.
Saint, our golden retriever puppy, smiling with healthy teeth in 2026.
by Hannah Maxey | Dec 18, 2019 | Other, Topics of Interest
I don’t know about you but when I hear or see the phrase “20/20 Vision,” I immediately think about eye exams. In that context the phrase is used to describe visual acuity (the clarity or sharpness of vision) at a distance of 20 feet. But VISION can be deeper than a physical ability to see the world around us. Vision can also mean the ability to see beyond the current state to future possibilities. This type of visioning is critical to advancing policy and improving health.
The Rearview Mirror
Ten years ago, Indiana did not have a clear “picture” of the health care workforce. We reactively identified workforce shortages if and when a community member/advocate came forward and requested assessment. From anecdotal information we knew we had shortages, but we just didn’t have the workforce data to prove it. (See map of Dental Shortage Areas from 2009.)
Workforce in Focus
Today Indiana is in a very different place. Because of investments in health workforce data infrastructure, we know where our health care workforce is and where it is not. (See 2019 map of Dental Shortage Areas). It took vision to get here. A vision that began with seeing past the problem (we don’t have the health workforce data we need to ID our shortage areas) to opportunities (collecting the data we need during health professional license renewal) and solutions (2018 Senate Enrolled Act 223, which ensures we get the data we need). As a state, we are now able to proactively identify workforce shortages. Other states are now looking to Indiana to learn how they too can craft a vision for bringing their workforce into focus.
The View Ahead
As the Bowen Center looks ahead to 2020, our line of sight has expanded and so has our vision. We’ve sharpened Indiana’s health care workforce lens, and now we have set our sights on informing broader health care policy. Workforce shortage identification is critical, but it is just the tip of the iceberg. We are excited to “pull-up” a chair in new conversations, use our expertise to bring problems into focus, and turn health improvement visions into reality.
by Hannah Maxey | Apr 22, 2019 | Other
At first blush you may wonder how workforce shortages and wellness could possibly be related. Workforce shortages contribute to the wellness of providers and the populations they serve. From the provider perspective, the symptoms of workforce shortages may sound like “I spend too many hours at work” or “I see too many patient appointments in a day.” Without sufficient support from peers and colleagues, providers are more likely to feel isolated, overwhelmed, and experience burnout. The bottom line: workforce shortages contribute to burnout and threaten provider wellness.
Now, you may be wondering how this impacts population wellness. Providers experiencing burnout are more likely to reduce the number of hours they work and/or leave practice all together. In underserved communities, provider burnout contributes to exacerbating existing workforce shortages and further threatens access to the health care services, including those critical to wellness (examples: vaccination, well-child visits, prenatal care.) It’s a vicious cycle.
How can we fix this problem? Policies to address workforce shortages are an important part of the solution. Loan Repayment Programs (LRP) support recruitment of providers in workforce shortage areas. These programs reduce provider debt burden and encourage practice in underserved communities. Over the last several legislative sessions in Indiana there have been more than 15 LRP bills proposed, and this year 4 bills are on the table. At the Bowen Center, we are keeping our finger on the pulse of these important initiatives and providing data and research to inform related conversations. Do you want more information? Contact us at Bowenctr@iu.edu.
