Texas has a Dentist shortage. Joining a compact with other states would help.

Originally published with Grover Norquist at the Austin American-Statesman. 

State lawmakers are addressing a number of challenges facing Texans and the state economy, including many that don’t get the media coverage they deserve, such as the worsening dental care crisis. Simply put, Texas does not have enough dentists and hygienists to meet current needs, let alone rising demand driven by population growth. Fortunately, the Legislature is considering a bipartisan solution that could bring swift relief: joining the Dentist and Dental Hygienist Compact (DDHC).
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Two companion bills filed in the Texas Legislature — Senate Bill 1109 and HB 1803 — would make Texas a member of this compact, enabling licensed dental professionals from other member states to practice in Texas without burdensome delays or redundant licensing hurdles. On March 31, the House Public Health Committee held a hearing on HB 1803, allowing Texans to hear firsthand about the compact’s benefits.

Across the country, this commonsense reform is gaining momentum. States from Arkansas to Virginia have already joined the DDHC, reflecting a bipartisan consensus that mobility and access matter. Texas nearly did the same last session: A bill for Texas to join the DDHC failed by one vote in the House, and didn't reach a vote in the Senate.

The case for compact membership is strong. According to the Kaiser Family Foundation, less than 29% of Texas’ oral health needs are currently being met. More than 2 million Texans live in one of the state’s 261 designated dental shortage areas, where delays in care can result in long-term health consequences.

Enabling licensed professionals from other states to quickly enter the Texas workforce would increase the supply of care, particularly in underserved communities. This could lower patient costs, improve outcomes and ease the strain on current providers. It would also benefit job-seekers — particularly experienced hygienists and dentists — who want to relocate to Texas without having to navigate bureaucratic obstacles.

​The Texas economy continues to roar thanks to the state's pro-growth policies, no income tax and commitment to free enterprise. But even the strongest economies face constraints. Population growth outpacing service expansion can quickly create friction — especially in health care. If those constraints aren’t addressed through smart reforms, the consequences will multiply: longer wait times, higher costs and missed opportunities to deliver essential care.

This is where the DDHC fits. It represents a targeted response to a real problem, offering near-term gains in provider availability while maintaining professional standards. But the broader conversation should not stop there.

Should Texas lawmakers enact HB 1803, it would mark a decisive step in the right direction. Still, the ultimate goal should be to remove government-imposed barriers to entry into dental care altogether. Whether trained here or elsewhere, qualified providers should be free to serve Texans without unnecessary red tape. This aligns with a broader principle: that markets, when left to function, produce abundance, not scarcity.

Milton Friedman famously argued that many licensing regimes are less about protecting the public than about protecting existing providers. Research confirms this: Occupational licensing inflates wages, restricts supply and increases costs without consistently improving service quality. In dental care, this means fewer options and higher prices for families who can least afford it.

The DDHC offers a meaningful reform. It doesn’t fix everything but brings us closer to a system where competition, not regulation, drives outcomes. By considering this policy, Texas lawmakers can reaffirm their commitment to healthcare access, workforce mobility and economic freedom.

In the end, it’s not just about dentists. It’s about restoring the basic right to work — and to receive care — without the government getting in the way.