www.lesswrong.com/posts/xAYbPv33gvZZJZsgo/dentistry-oral-surgeons-and-the-ineffi...

The post links the Balanced Budget Act of 1997 (BBA) to a “soft cap” on residency programs and then claims this is why the U.S. has “far less” dentists than demand.

However, the BBA’s well-known Medicare GME “cap” is about limiting Medicare-reimbursable residents at hospitals—specifically in allopathic and osteopathic medicine (physician residency training), not the pipeline that produces dentists.

• A legislative summary explicitly states the BBA’s resident limit “only includes residents in a hospital's approved medical residency training program in allopathic and osteopathic medicine,” i.e., physician training. That contradicts the post’s implication that this cap constrains the number of dentists.
• Peer-reviewed research further states that dental and podiatry programs are exempt from the 1997 BBA cap, meaning the BBA cap cannot be the mechanism that limits dental GME positions, let alone the overall number of dentists.
• Separately, the American Dental Association’s licensure overview describes that the educational requirement for licensure is a DDS/DMD from a CODA-accredited dental education program—i.e., the dentist workforce is primarily produced via dental schools (and state licensure requirements), not via “graduate medical residency programs.”

Putting these together: the BBA GME cap may affect physician residency financing/supply, but the claim that it (via “graduate medical residency” caps) explains why the U.S. has too few dentists is not supported and is directly contradicted by sources describing what the BBA cap covers and the exemption status of dental programs.

The post states oral surgeons “perform root canals.”

In standard U.S. dental practice, root canal treatment is an endodontic procedure primarily performed by endodontists (root canal specialists) and also by some general dentists.

• The American Association of Endodontists describes root canal treatment as being performed by “an endodontist who specializes in such treatment.”
• The American Association of Oral and Maxillofacial Surgeons (AAOMS) describes scenarios where, after a root canal, a patient may be referred to an oral and maxillofacial surgeon for an apicoectomy (a surgical root-end procedure) when “a root canal alone isn’t sufficient.” This presentation treats the root canal as a prior (non-OMS) step and OMS involvement as surgical follow-up—not that OMSs are the practitioners who perform routine root canal therapy.

So, while oral surgeons can be involved in related surgical endodontic procedures (e.g., apicoectomy), the blanket statement that oral surgeons “perform root canals” is inaccurate as a description of who generally performs root canal treatment.