Long Term Dental Work Force Build-Up and DMFT-12 Improvement in the European Region.

Abstract

As Mikiko Hayashi noticed in an amazingly poetic way, dentistry remains in majority of national health systems across the globe: “the Cinderella of health care.” Regardless of undisputed progress of scientific knowledge there is a growing gap in service utilization patterns among the world's rich and poor citizens. The first tend to consume much of a rather cosmetic expensive treatments without essential health added value. At the same time almost three billion of people belonging to the low income households, lack access to basic dental services or do not pay a visit to a dentist for years (Hayashi et al., 2014). Although the issue of affordability is high at stakes in these countries, uneven distribution between rural and urban areas adds to the challenge. Prime example is definitely India whose giant population was served by 117,825 registered dentists out of whom almost 90,000 were concentrated in only four out of thirty Indian federal states (Vundavalli, 2014). Another case is Australia with its huge geographic area and recently reported ratio of almost 40,000% differential between dentist density in the suburbs of core coastline cities and desert Aboriginal communities (Tennant et al., 2013). Due to international efforts addressing global oral health deficiencies national capacities worldwide have increased sharply over past few decades (Petersen, 2003). Important part of this capacity build-up was grounds laid down by establishment of “WHO Oral Health Country/Area Profile Programme” (or “CAPP”) by the World Health Organization (WHO) back in 1990s. Its cause was the fact that evidence based policy needed reliable and internationally comparable field data. The two main WHO Collaborating Centers whom we own existence and maintenance of these public registries are the Niigata University, Japan and Faculty of Odontology, Malmo, Sweden. The first is in charge of Periodontal Country Profiles and the latter pursues the uneasy task of providing broader Country Oral Health Profiles. Nevertheless other comprehensive sources of evidence on oral health status across regions and nations developed independently. FDI World Dental Federation provides access to the its own Data Hub which consists of fusioned national data sources originating from WHO and World Bank (WB) and Globocan official registries. The European Health for All database (HFA-DB) created and updated by the WHO Office for the European Region and refers to a total of 53 countries located in the European continent. Some of the aforementioned investments allowed for revelation of hidden long term national patterns in oral health care and identification of core weaknesses that might serve as appropriate policy targets in future. So far there is scarcity of published evidence comparing efficiency of all European countries in dental workforce build-up and its relationship to the dental health status of school children in a several decades long time horizon.