Dental Workforce Research Articles

Sex and academic stage differences in work-related musculoskeletal disorders pain among dental students. A cross-center cross-sectional study

ABSTRACT Objective Dental professionals are highly vulnerable to work-related musculoskeletal disorders (WMSD). As females, who are more prone to WMSD, represent a growing proportion of the dental workforce, this study explored sex differences in WMSD-pain prevalence among dental students, and differentiated it between preclinical and clinical students. Methods A multi-center cross-sectional study was conducted among dental students at three U.S. dental schools. An anonymous survey assessed prevalence of WMSD pain over the last 12 months and 7 days using the Nordic Musculoskeletal questionnaire. Sex and academic stage differences were analyzed with independent t-tests and chi-square, adjusted for demographics and occupational habits (working hours, self-reported ergonomics, loupes, sport engagement) with ANCOVA. Results Among 175 students (26.6±3.6 years, 66.9% females), 93.7% and 57.7% reported WMSD-pain in the past 12 months and 7 days, respectively. Females scored higher than males in pain intensity (p=.025), WMSD-pain prevalence in the past 7 days (p=.006), and number of painful body sites in the past 12 months (p=.006) and 7 days (p<.001). Clinical students had higher WMSD-pain prevalence (p<.001) and number of painful body sites (p<.001) in the past 7 days than preclinical students. Differences remained significant only among females. Conclusion A high prevalence of WMSD-pain was evident in dental students, with significant sex and academic stage differences.

Transforming undergraduate dental education: the impact of artificial intelligence

Artificial intelligence (AI) is a rapidly evolving area, having had a transformative effect within some areas of medicine and dentistry. In dentistry, AI systems are contributing to clinical decision-making, diagnostics and treatment planning. Ongoing advances in AI technology will lead to further expansion of its existing applications and more widespread use within the field of dentistry. The predicted transformation of current practice within dentistry brought about by AI necessitates the education of undergraduate dental students on the topic of AI. AI will act as a complementary tool to clinical expertise and skill, rather than a replacement. AI education frameworks should integrate with existing traditional dental education. It is important that dental students develop a sound understanding of the ethical considerations surrounding AI, ensuring its safe and responsible use. This article aims to consider the status of current undergraduate dental education and the possible impact of AI, examining both the challenges and opportunities, and the practicalities, of incorporating AI into existing undergraduate dental curricula. Understanding and envisioning the future landscape shaped by AI will allow for development of a future dental workforce who are skilled, confident and responsible AI users.

Saudi dental postgraduate education (2013–2023): demographic shifts and potential employment challenges

BackgroundDentistry is essential for oral health, focusing on the diagnosis, prevention, and treatment of oral diseases. In recent decades, Saudi Arabia has expanded its dental education system, adding new dental schools and postgraduate programs to meet the growing demand for professionals. This study provided a detailed analysis of the trends and demographic characteristics of dental postgraduate programs in Saudi Arabia between 2013 and 2023.MethodsThis retrospective study collected data on dental postgraduate programs from the Saudi Commission for Health Specialties (SCFHS) for the period from January 2013 to December 2023. Data were gathered on program types, gender, nationality, and geographic distribution. Descriptive statistics were used to analyze trends and distributions. Key variables included the number of postgraduate dental specialty programs, enrolled students, and training levels (board, fellowship). Institutional Review Board (IRB) approval was obtained, and the data was processed using Microsoft Excel 2016.ResultsThe study revealed a total of 1,520 dental postgraduates, with a near-equal gender distribution (51.4% males and 48.6% females). Saudi nationals represented 94.8% of board residency graduates, while 2.4% were non-Saudis. Riyadh had the highest concentration of postgraduates, followed by Makkah. A significant increase in postgraduate enrollment was observed, peaking at 398 in 2023.ConclusionsThe findings indicate significant growth in Saudi dental postgraduate programs, with regional disparities and increasing numbers of graduates. However, this growth raises concerns about potential unemployment among dental postgraduates, as the number of available positions may not match the surge in graduates. Policymakers must evaluate the expanding programs and their potential impact on the Saudi dental workforce.

Foundation dentists’ attitudes and experiences in providing dental care for dependant older adults resident in care home settings

IntroductionThere is a continued increase of older dependant adults in England. Foundation Dentists (FDs) are often the dental workforce being tasked with providing dental care to dependant older adults resident in care home settings. This study explores whether FDs have the experience and confidence to deliver this.AimThis service evaluation aimed to explore FDs’ attitudes, perceptions and experiences delivering dentistry to dependant older adults’ resident in care home settings; to help inform workforce and service delivery planning.MethodsAll North West England (NW) FDs were invited to complete a semi-structured questionnaire at a regional study session. Results were analysed using descriptive and thematic analysis.ResultsThere were 93 (80.1%) respondents, with the majority aged 20–24 years old (56, 60.2%), female (57, 61.3%) and with an United Kingdom undergraduate dental degree (88, 94.6%). Most respondents had no experience in delivering care in a care home setting at either undergraduate (85, 91.4%) or FD level (84, 90.3%). Only 14 respondents (15.1%) reported confidence to deliver dentistry in a care home setting.ConclusionTo deliver dental care for dependant older adults resident in care home settings, FDs require additional training and clinical support. There is a need to review the undergraduate dental curriculum and NHS postgraduate training programmes to increase knowledge and skills for this vulnerable group.

Oral health services provided for Aboriginal and Torres Strait Islander peoples in Australia: a scoping review.

ObjectiveThe shortage of oral health professionals in rural and remote regions of Australia directly impacts the access to oral health services for people who live in these regions, including Aboriginal and Torres Strait Islander peoples. This scoping review aims to explore where and how these services are provided for Aboriginal and Torres Strait Islander peoples and the relevant workforce model used.MethodsElectronic databases, including MEDLINE, EMBASE, Cochrane, and CINAHL, were searched. Grey literature searches included the Australian Indigenous HealthInfoNet webpage, Australian Institute of Health and Welfare, and Advanced Google search.ResultsOral health services were classified into the following categories: (1) clinical oral health services, (2) oral health promotion to improve oral health awareness, knowledge, attitudes, behaviours, or skills at patient/community level, and (3) oral health promotion including the use of single clinical interventions (e.g. fluoride varnish). Services were delivered in a variety of settings including community health clinics and schools or using mobile dental equipment. Both the dental and non-dental workforce were utilised to provide these services. Limited data were found on the experiences and challenges faced by the workforce that provide these services.ConclusionOral health services provided for Aboriginal and Torres Strait Islander peoples in rural and remote regions of Australia vary in service type, location, and workforce involved. Future research is required to explore the experiences and support of this workforce. This can enhance delivery of culturally and clinically safe oral health services for Aboriginal and Torres Strait Islander peoples, particularly in rural and remote regions.

A delphi study on the feasibility of community-based oral function rehabilitation exercises and the dental hygienist workforce adequacy

A delphi study on the feasibility of community-based oral function rehabilitation exercises and the dental hygienist workforce adequacy

Dental Clinic Deserts in the US: Spatial Accessibility Analysis

Little is known about the spatial accessibility to dental clinics across the US. To map the spatial accessibility of dental clinics nationally and to examine the characteristics of counties and US Census block groups with dental care shortage areas. Cross-sectional study of US dental clinics in 2023 using data from the IQVIA national practitioners' database, which includes 205 762 active dentists. Data were analyzed from November 2023 to April 2024. Socioeconomic characteristics of block groups and counties including rurality, area deprivation, racial and ethnic segregation, and uninsured population. Enhanced 2-step floating catchment area method with a 30-minute drive time impedance was used to calculate the accessibility score to dental clinics at the block group level. The outcomes were dental clinic shortage areas and inequality in access to dental clinics. Nearly 1.7 million people in the US (0.5%) lacked access to dental clinics within a 30-minute drive. This included 0.9 million male (52.2%), 1.2 million White (71.0%), 52 636 Black (3.0%), and 176 885 Hispanic (10.2%) individuals. Approximately 24.7 million people (7.5%) lived in dental care shortage areas (defined as <1 dentist per 5000 population). There was a significant difference in spatial accessibility scores between rural and urban areas, with 1 dentist for every 3850 people in rural areas and 1 dentist for every 1470 people in urban areas. Additionally, there were 387 counties with significant disparities in access to dental clinics. Rural block groups (23.9 percentage points [pp]; 95% CI, 23.6-24.3), block groups with higher levels of Black (1.5 pp; 95% CI, 1.3-1.7) and Hispanic (4.5 pp; 95% CI, 4.3-4.8) segregation, and block groups with the highest levels of area deprivation (5.5 pp; 95% CI, 5.1-5.9) were more likely to experience dental care shortages compared with urban block groups and those with lower levels of segregation and area deprivation. Moreover, rural counties (11.3 pp; 95% CI, 8.9-13.7), counties with a high uninsured population (3.0 pp; 95% CI, 1.5-4.4), and counties with high levels of deprivation (5.8 pp; 95% CI, 2.1-9.5) were more likely to have inequality in access to dental clinics. In this cross-sectional study of US dental clinics, there was geographic shortage and maldistribution of the dental workforce. These findings can support dental workforce planning efforts at the federal and state levels to encourage dentists to practice in underserved areas to reduce disparities in access to dental care.

Assessment of Oral Histology Knowledge and Its Application in Clinical Orthodontics, Operative Dentistry, Oral Medicine, and Oral Surgery

Objective: This study aims to assess the knowledge of oral histology among fifth-year dental students in Iraq and evaluate its relevance to various clinical dental disciplines, including orthodontics, operative dentistry, oral medicine, and oral surgery. Methods: A cross-sectional survey was conducted from February to May 2024 among dental students from both public and private institutions in Iraq. Participants were recruited through targeted online advertisements on platforms such as Telegram, WhatsApp, and Facebook. Results: The results compare clinical and basic knowledge between younger and older dental students. Younger students scored higher in understanding basic concepts like structural changes in the periodontal ligament, bone remodeling, tooth eruption enamel structure, cavity design and surgical interventions. However, older students excelled in clinical areas such as maxillofacial development, orthodontic appliances, and developmental anomalies. Conclusion: This study provides insights into the perceived value of oral histology education among dental students and its application in clinical practice. The findings may be encouraging early clinical involvement while reinforcing basic science concepts can lead to a more well-rounded and confident dental workforce.

Trends in North Carolina's Oral Health Workforce.

Work remains in North Carolina to effectively increase access to oral health care and address the maldistribution of the dental workforce. This study provides updated data on the oral health workforce (from 2000 to 2022) in response to the recommendations outlined in the North Carolina Institute of Medicine Oral Health Transformation Task Force report.

Dental Hygienists' Influence on Oral Health Knowledge, Attitudes and Behavioural of Patients and Effectiveness on Improving Patients' Periodontal Status-Evaluations of a Hospital Based Oral Hygiene Training Program in China.

To evaluate the possibility of integrating dental hygienists (DHs) into the dental field in China, and investigate its effectiveness on improving patients' knowledge, attitudes, self-care behaviours as well as their periodontal status. A hospital-based oral hygiene training program was developed at Sir Run Run Shaw Hospital's (SRRSH) Dental Clinic with the support of two registered DHs from Loma Linda University in California. A questionnaire evaluating oral health knowledge, attitudes and behaviours was conducted in patients who visited SRRSH's Dental Clinic. Scores of oral health knowledge and proportions of positive oral health attitudes and favourable self-care behaviours were estimated between patients treated and not treated by DHs (DH group and NDH group). The improvements in patients' periodontal conditions following non-surgical periodontal therapy (NSPT) administered by DHs at the Dental Clinic of SRRSH, as assessed through the measurement of periodontal pocket depths and the incidence of bleeding upon probing. Patients in DH group exhibited relatively better results in several aspects of oral health knowledge, attitudes and behaviours, compared to those in NDH group. Moreover, NPST performed by DHs significantly improved the periodontal status of the patients, with a remarkably reduction in periodontal pocket depth and bleeding on probing. Integrating DHs into SRRSH's Dental Clinic showed effectiveness in enhancing patients' oral health knowledge, attitudes, behaviours and succeeded in improving patients' periodontal status. This program demonstrated that incorporating DHs into dental care team is not only practical but also enhances the value of the dental workforce in China.

Imbalances in the oral health workforce: a Canadian population-based study

BackgroundIn Canada, a new federal public dental insurance plan, being phased in over 2022–2025, may help enhance financial access to dental services. However, as in many other countries, evidence is limited on the supply and distribution of human resources for oral health (HROH) to meet increasing population needs. This national observational study aimed to quantify occupational, geographical, institutional, and gender imbalances in the Canadian dental workforce to help inform benchmarking of HROH capacity for improving service coverage.MethodsSourcing microdata from the 2021 Canadian population census, we described workforce imbalances for three groups of postsecondary-qualified dental professionals: dentists, dental hygienists and therapists, and dental assistants. To assess geographic maldistribution relative to population, we linked the person-level census data to the geocoded Index of Remoteness for all inhabited communities. To assess gender-based inequities in the dental labour market, we performed Blinder-Oaxaca decompositions for examining differences in professional earnings of women and men.ResultsThe census data tallied 3.4 active dentists aged 25–54 per 10,000 population, supported by an allied workforce of 1.7 dental hygienists/therapists and 1.6 dental assistants for every dentist. All three professional groups were overrepresented in heavily urbanized communities compared with more rural and remote areas. Almost all dental service providers worked in ambulatory care settings, except for male dental assistants. The dentistry workforce was found to have achieved gender parity numerically, but women dentists still earned 21% less on average than men, adjusting for other characteristics. Despite women representing 97% of dental hygienists/therapists, they earned 26% less on average than men, a significant difference that was largely unexplained in the decomposition analysis.ConclusionsAccelerating universal coverage of oral healthcare services is increasingly advocated as an integral, but often neglected, component toward achieving the health-related Sustainable Development Goals. In the Canadian context of universal coverage for medical (but not dentistry) services, the oral health workforce was found to be demarcated by considerable geographic and gendered imbalances. More cross-nationally comparable research is needed to inform innovative approaches for equity-oriented HROH planning and financing, often critically overlooked in public policy for health systems strengthening.

Utilisation of the dental workforce: a service evaluation in one dental institute.

Objective This study examines the skill set and utilisation of dental care professionals (DCPs) in secondary and tertiary dental care roles.Methods DCPs were surveyed across various specialities using the General Dental Council's Scope of practice as a reference.Results Dental nurses employ 23 out of 30 identified skills, dental therapists use 28 out of 32, and dental hygienists perform 27 out of 29 of their skills. Dental technicians use 17 out of 20 skills within their scope; however, clinical dental technicians only employ 3 out of 20 skills regularly. The majority of participants expressed a desire for further training and skill utilisation.Discussion DCPs possess diverse skill sets and a commitment to ongoing development. However, challenges, including educational priorities, patient referrals and treatment constraints, limit their scope in secondary and tertiary care.Conclusion Enhancing DCPs' contributions to patient care requires collaboration with dentists and addressing systemic barriers in secondary and tertiary dental care. Promoting additional training and full skill set utilisation can improve the dental care workforce to meet evolving patient and population needs.

Why Is Caries Prevention in Children So Difficult? A Narrative Opinion.

Caries is among the most common non-communicable diseases worldwide, yet it is commonly described as preventable. Caries prevention is, however, difficult and complex, since the disease has strong social, parental, behavioral, political, medical/genetic, and psychological elements, and the payment models are targeted at traditional conservative care. The aim of this paper is to discuss some key issues that make caries prevention in children be perceived as "difficult": i) the communication gap between researchers and clinicians, creating unrealistic expectations of intervention efficacy; ii) the skewed distribution of caries and the problem of reaching children with the highest need; iii) limited access to care, which is a threat to oral health, in particular in low-socioeconomic-status, underserviced, and remote communities; and iv) the need to adopt behavior change models to affect the modifiable risk factors that are shared with other non-communicable diseases. Dentists cannot simply rely on fluoride exposure; proper education and training in caries risk assessment, behavior change models targeted at oral hygiene and sugar intake, and collaboration with primary healthcare and local school authorities are avenues that aid in caries prevention and reduce the uneven burden of the disease. Online education and mobile apps may help to promote oral health in areas with shortages of dental work force.

Impact of COVID-19 on Depression, Anxiety and Stress of Dental Students: A Systematic Review.

To determine the impact of the COVID-19 pandemic on depression, anxiety and stress of dental students by way of a systematic review. This review was conducted following the Cochrane Handbook for Systematic Reviews. An electronic search was conducted for the period January 2020 to February 2023. Quality assessment was evaluated in accordance with the Newcastle-Ottawa Scale. Frequency distribution was calculated for stress, anxiety and depression associated with students' gender, year of study and living circumstances. Twenty-three studies were eligible for inclusion in the final review. Variables contributing to stress, anxiety and depression of dental students include gender, year of study and living circumstances. Being female is the most significant factor impacting on mental health. Results emphasise the need for dental institutions to develop targeted intervention programmes for more vulnerable students. Failure to act in a future pandemic event could result in ongoing psychological issues that persist following graduation, resulting in unfit dentists who may potentially affect the quality of the dental workforce.

Scenario Modeling for Dentistry in Malaysia: Utilization, Privatization, and Specialization

Abstract Aim: To study to model future clinical dental workforce scenarios in Malaysia, in relation to population need–demand, to inform future change. Materials and Methods: A system dynamics (SD) model was developed in Vensim-software to model the need/demand and supply for dental care across public–private sectors over 3 decades (2010–2040). This model included two sub-models relating to “need/demand” and “supply,” drawing on national evidence from two previous studies (student career surveys and interviews of key stakeholders nationally), together with relevant available data. This SD model provided the baseline model (S1) for Malaysia and four-distinctive-scenarios (S2–5), involving enhancing generalists–specialists across public–private sectors. An additional scenario (S6) was run to optimize workforce utilization, informed by career expectations of emerging graduates drawing on earlier scenarios (S2–5). Results: Modeling future five-scenarios highlighted the gap in dental workforce nationally across both sectors could range from a surplus of a total of 3739 dentists and 817 therapists in the baseline scenario to a total shortfall of 1249 dentists and surplus of 817 therapists by the year 2040, influenced by dentist working patterns, specialization, and privatization. Increasing the potential for specialist training and permitting emerging graduates’ to working part-time, while optimizing public sector primary care, and responding to the career expectations of emerging graduates, has the potential to absorb potential oversupply, and, thus, utilize the entire clinician dental workforce in Malaysia in the medium term. Conclusion: The findings of this model demonstrate the short-term requirement to expand the Malaysian dental workforce to meet dental needs of the population, highlighting that continued production at the current rate will result in oversupply, unless action is taken to maximize primary care, enhance specialization, and embrace flexible working to meet career expectations of graduates.

A policy option towards improving efficiencies in Victorian public oral healthcare.

International oral health policy directions led by the World Health Organisation call for the inclusion of oral health within universal health coverage. The aim of this study is to perform a budget impact analysis of a policy option for a more cost-efficient oral health workforce skill-mix (dentists and oral health therapists) to provide public oral healthcare in Victoria, Australia. Two hypothetical standard care pathways were developed. A dynamic population Markov model in TreeAge software, with a time horizon of 6years. Two scenarios were modelled to determine: (1) base-case scenario: the threshold the dentist workforce could reduce per year, while achieving the same service delivery outputs, and (2) alternative scenario: the potential cost-savings for utilising an optimally cost-efficient oral health workforce skill-mix. The threshold analysis showed a minimum reduction of 13% of the dentist workforce being replaced with oral health therapists can occur without having any impact on the same service delivery outputs. Under the alternative scenario, the potential cost-savings would be AUD$1,425,037 (standard deviation 58,954). Governments and policy-decision makers should consider strategies in training, attracting, and retaining oral health therapists to achieve an optimally cost-efficient oral health workforce skill-mix when delivering public oral healthcare.

Reflections on ethnic diversity within a dental desert.

The demographics of the dental workforce have changed significantly in recent years, with regard to both gender and ethnicity. Ethnic diversity within dentistry does not align with UK population data, with some groups less well-represented than others, such as those of Black or Afro-Caribbean heritage. Although multiculturalism has developed throughout the UK, it is much less advanced within rural areas. Rural communities have a less ethnically diverse population and this has been identified as a challenge when looking to recruit dentists and other dental care professionals from a Black, Asian or minority ethnic (BAME) background.Recruitment and retention of dentists to rural areas is a major issue and it is vitally important to ensure that all members of the dental profession feel adequately supported and welcome. Addressing the shortage of dental professionals in rural areas is crucial in improving dental access. However, this task becomes more complex when considering the increasing number of BAME students and graduates from a metropolitan background, and a continuing lack of multi-culturalism within rural communities. Identifying and understanding the factors which influence BAME dental professionals' decisions to relocate to rural areas is vital for developing effective strategies to attract and retain diverse talent within these communities.This opinion article considers existing literature, while drawing upon personal experiences as a Black student in the South West of England, in order to explore the barriers to working in rural areas as an individual from a minority ethnic group. Socioeconomic challenges, cultural isolation and limited rural experience are identified as factors that can deter Black and other minority ethnic dentists from living and working in rural areas.

Prevalence of Medical Conditions and Medication Usage: Implications for Oral Health among Older Adults in Rural Victoria

(1) Background: A study was undertaken to provide a comprehensive profile of the prevalence and distribution, by selected socio-demographic characteristics, of chronic diseases and health conditions including those that impact the oral health and oral health self-care of independently living older adults in rural areas of the state of Victoria; (2) Methods: The study analyzed data from the Crossroads-II project, with a total of 1407 participants aged 55 years and older. Participants responded to questionnaires about their medical health history, health service use, and socio-demographics. In total, 572 attended a 2-h health screening that included an assessment of prescribed medications; (3) Results: Most participants were female (55.3%), with a mean age of 69.1 (SD = 9.2) years. Participants had a high prevalence of medical conditions; the most common were high blood pressure, arthritis, high lipids, hearing loss, and chronic pain. Almost all participants reported taking medications, with an average of 4.3 medications per person. Among those who attended the health screening, 78.1% were taking medications that could cause xerostomia (dry mouth); (4) Conclusions: This study provides initial information on the prevalence of medical conditions, medication usage, and the potential impact on the oral health of older adults living in rural Victoria. This information would be valuable for healthcare and dental workforce planning, policy development, and improving the overall well-being of this population.

The oral health care system in Libya: a case study

BackgroundThis study aims to describe the Libyan oral health care system in terms of its structure, function, workforce, funding, reimbursement and target groups.MethodsA single descriptive case study approach and multiple sources of data collection were used to provide an in-depth understanding of the Libyan oral health care system. A purposeful sample of the key informants (Managers of oral health centers, dentists of various specialties with experience in the field, dentists, nurses, dental technicians, and officials in the affairs of medical insurance) was recruited. The case and its boundaries were guided by the study’s aim. Both qualitative and quantitative analyses were conducted. Descriptive statistics were used for quantitative data. Framework analysis, informed by the study objectives, was used to analyze interviews and documents.ResultsThe analysis showed that oral health services are integrated into medical services. The provision of dental care is mainly treatment-based, in the private sector. The oral health services in the public sector are mainly emergency care and exodontia. The dental workforce included in the study were mostly dentists (89% General Dental Practitioners (GDPs), 11% specialists), with a marked deficiency in dental technicians and nurses. Around 40% of dentists work in both the private and public sectors. The government provides the funding for the public sector, but the private sector is self-funded. No specific target group(s) nor clear policies were reported. However, the system is built around primary health care as an overarching policy. Dental caries is the most common oral problem among Libyan preschool children affecting around 70% and is the most common cause of tooth loss among adults.ConclusionThe oral health care system in Libya is mainly privatized. The public health services are poorly organized and malfunctioning. There is an urgent need to develop policies and plans to improve the oral health care system in Libya.

Assessment of the Need for Work-life Balance Among Dental Professionals

Abstract Background: In the current fast-moving and dynamic professional world, establishing an optimal work-life balance has become a top priority for individuals who desire success at the workplace and in their personal lives as well. This article glimpses into the many aspects of work-life balance, discussing its importance, concerns, and some practical suggestions for achieving this balance. The objective of this study was to find out the awareness and knowledge regarding the necessity for work-life balance among dental professionals. Materials and Methods: A questionnaire consisting of 15 questions intended to assess the interdependency of work and nonwork day-to-day activities was asked to be filled out by the practicing dental professionals. The results were based on the responses recorded by 30 clinically active dentists from various areas of Maharashtra state. Results: The survey results provide a statistically nonsignificant difference in work-life balance among dentists as the statistical difference was &lt;0.05. The inference of this study lays a foundation for ongoing discussions and actions aimed at further improving the work-life balance of dental practitioners, ultimately contributing to a healthier and more sustainable dental workforce. Conclusion: This study serves as an informative resource for dental professionals trying to negotiate the difficulties of today’s work-life balance while cultivating a way of life prioritizing holistic development.