Dental Workforce Research Articles

Recommendations for remaining agile in the face of a dental faculty workforce shortage.

Dental education is facing a faculty workforce shortage. Lack of preparation risks faculty, student, and staff morale and is an impediment to institutional growth and innovation. Administrators and faculty must consider strategies to better prepare for, and be successful within, a faculty shortage environment. We review strategies utilized by health professional institutions that have confronted faculty workforce shortages. These strategies were grouped into four domains reflecting the organizational units that typically direct and initiate change within dental education institutions: budget and finance, human resources, organizational structure, and curricular structure. Recommendations using a four-pronged approach based on these domains have been developed for remaining agile in the face of a faculty workforce shortage. Local needs assessments and strategic planning are the first steps in highlighting institutional strengths and identifying gaps within each of the domains. Faculty development and retention efforts, as well as increasing curricular efficiencies, are essential for success across all domains.

Sociodemographic Changes and Oral Health Inequities: Dental Workforce Considerations.

By midcentury, the US population will be remarkably more racially and ethnically diverse, with a dramatic increase in the proportion of older adults. This report addresses ongoing oral health disparities and inequitable access to care related to these changes, with emphasis on implications for the workforce, taking note of effects of the COVID-19 pandemic. Considering that social determinants shape health behaviors, reflection on the most effective type of dental workforce should take into account population characteristics and the relationship of oral health with overall health and general well-being. The dental workforce composition will need to mirror changing demographics, and effective dental health teams will be characterized by cultural competence, humility, readiness, and capacity to adapt to changes. In addition, the influence of social histories and the pandemic on health and dental care utilization is important. Equally important are the inclusion of oral health literacy in treatment planning and disease prevention, as well as oral health-related quality of life in considering outcomes of care. Providing patient-centered care for a diverse population requires tailored treatment modalities, as well as intra- and interprofessional approaches. In this way, the whole person can be cared for, including those with special health care needs, whether related to chronic disease, mental health conditions, or behavioral, physical, and social differences. Changing demographics will affect the delivery of oral health care, including who can best provide care and how, what the needs are, and in what ways prevention and treatment can most effectively be accomplished. The education of dentists must address unmet population needs, including for those with special health care concerns and older adults. These population groups are influenced by a variety of social determinants, and provision of services may need to occur in alternative care delivery settings. Identifying and addressing the needs of every patient within this broad array of new requirements will challenge dental professionals to redefine what it means to be a health care practitioner. This article describes how sociodemographic changes in the United States will challenge the dental workforce in new ways and points to research and practice needs to address these challenges. Oral health disparities and the changing oral health care needs of patients from diverse and underserved groups are discussed, with a focus on the implications for delivery of care and policies that are needed to improve oral health outcomes for all.

Faculty diversity, equity, and inclusion in academic dentistry: Revisiting the past and analyzing the present to create the future.

In 2021, NIDCR published the landmark report "Oral Health in America." It described that while oral health-related research and care has seen amazing progress, oral health inequities and lack of oral care for large segments of the US population have not improved. This situation plus the predicted increase of the diversification of the US population requires decisive actions to ensure that future dentists will be optimally prepared to provide the best possible care for all patients. A diverse dental educator workforce plays a crucial role in obtaining this goal. The objectives of this document were threefold. Aim 1 was to analyze past and current trends in the diversity and inclusion of historically underrepresented ethnic/racial (HURE) and marginalized (HURM) dental faculty members. Aim 2 focused on reviewing best practices and challenges related to achieving dental faculty and leadership diversity and inclusion. Aim 3 was to develop recommendations for increasing the diversity and inclusion of dental faculty in the present and future. An analysis of ethnicity/race and gender faculty data collected by the American Dental Education Association (ADEA) in 2011-2012 and 2018-2019 showed that achieving faculty diversity and inclusion has been an ongoing challenge, with limited success for faculty from HURE backgrounds. In order to create this much-needed change, best practices to increase the applicant pool, change recruitment strategies, and develop solid retention and promotion efforts were described. Research discussing the challenges to creating such changes was analyzed, and strategies for interventions were discussed. In conclusion, evaluations of efforts designed to create a more diverse and inclusive work force is crucial. Institutions must evaluate their diversity data, practices utilized, and the policies implemented to determine whether the desired outcomes are achieved. Only then will the future dental workforce be optimally prepared to provide the best possible care for all patients in the United States.

Maintaining a strong rural dental workforce.

This study was designed to examine demographics of University of Nebraska Medical Center College of Dentistry graduates over a recent 10-year period and factors related to their choice of rural or urban practice. Findings were compared to similar previous studies to analyze trends. Using data from the annual Health Professions Tracking Service 2019 Dentistry Profile survey, we examined the demographic information of 169 graduates from 2009 to 2018 practicing in Nebraska at the end of 2018. We analyzed factors such as rural or urban high school graduation, gender, and other background information to explore associations with their 2018 practice location (urban vs. rural) using chi-square tests and logistic regression. This study found that some demographic variables were associated with future practice location. Specifically, a higher proportion of graduates of rural high schools chose to work in a rural location (60%) relative to those who graduated from an urban high school (18%) (p < 0.0001). A higher proportion of men (50%) selected rural practice compared to women (33%) (p = 0.02). Only 17 graduates who attended high school outside of Nebraska stayed to practice in Nebraska, and there was a lower proportion of these graduates working in rural locations (18%) relative to in-state high school graduates (45%) (p = 0.03). We found significant positive associations between dentists who chose rural practice and demographic factors such as being rural high school graduates, male, and in-state predental residents. Our findings differ from descriptive results of similar previous studies.

Practice patterns of postgraduate trained dentists in the United States

Postgraduate dental (PGD) primary care training has grown significantly. This study examines the individual, educational, community, and policy factors that predict practice patterns of PGD-trained dentists. Individual dentist records from the 2017 American Dental Association Masterfile, with indicators of Medicaid participation and practice in a Federally Qualified Health Center (FQHC), were linked to postdoctoral training, community/practice location, and state policy factors. Generalized logistic models, adjusted for these factors, were used to predict PGD-trained dentists: (1a) serving Medicaid children, (1b) accepting new Medicaid patients, and (2) working in an FQHC. Individual attributes that predicted serving Medicaid children included all race/gender combinations (vs. White females), and foreign-trained dentists and contractors/employees/associates (vs. practice owners). Black women are most likely to work in an FQHC. Residency attributes that predicted serving Medicaid children and working in an FQHC were Health Resources and Services Administration postdoctoral funding and being community based. Dentists practicing in rural or high-poverty communities were more likely to serve Medicaid children and work at FQHCs. States with higher levels of graduate medical education investment, higher Medicaid rates, and more generous adult dental Medicaid benefits increased the likelihood of serving Medicaid children, while states with more expansive adult dental Medicaid benefits increased the likelihood of working in an FQHC. Federal training investment in PGD education combined with Medicaid payment and coverage policies can strongly impact access to dental care for vulnerable populations. Yet, oral health equity cannot be achieved without increasing dentist workforce diversity.

A Teledentistry Pilot Study on Patient-Initiated Care.

COVID-19 has challenged the public dental workforce in their ability to continue providing routine oral health care services. To mitigate the risk of COVID-19 transmission to staff and patients, Teledentistry was implemented in many parts of the world, mainly to provide remote consultations, undertake triage, and offer preventive educational sessions. The aim of this paper is to describe Dental Health Services Victoria’s (DHSV) patient-initiated Teledentistry model of care implemented during peak COVID transmission in Victoria. The Teledentistry model supported patient-centered care involving active collaboration and shared decision making between patients, families, and clinicians in designing and managing remote care plans. DHSV’s eligible patient cohort includes disadvantaged population groups with greater oral health needs. Strong emphasis was placed on the simplicity and user friendliness of the Telehealth platform, as well as the support for patients with low technology literacy. Consumers and dental workforce were consulted and modifications to the use of language and services were undertaken before the launch. A total of 2492 patients accessed Telehealth services between May 2020 and April 2021. Approximately 39% of patients were born in a country other than Australia. A total of 489 patient-reported experience measures (PREMs) were received. Patients agreed or strongly agreed that the care they received met their needs (87%); they received answers to their questions (89%); they left their visit knowing what is next (87%); they felt they were taken care of during their visit (90%); and they felt involved in their treatment (89%). Teledentistry enabled patients to initiate access to care and consult with dental workforce remotely and safely during peak pandemic.

Desirability Optimization Based on the Poisson Regression Model: Estimation of the Optimum Dental Workforce Planning

Aim: This study aims to estimate the optimum number of dentists needed by determining the social and economic variables that affect the dental workforce planning in Turkey. &#x0D; Method: A desirability optimization model based on the Poisson regression model was used to evaluate the importance of the variables of this study and to calculate the optimum values of the variables. The data used in the study cover the years 1960-2018. Population (x_p), gross domestic product per capita (x_pc), life expectancy (x_le), and literacy rate (x_lr) were considered as input variables affecting the dental workforce (y_d). &#x0D; Findings: The values of deviance R2, adjusted R2, and Akaike Information Criterion (AIC) were computed as 0.9941, 0.9941, and 960.11, respectively, which confirm the validity of the Poisson statistical test. The dual mechanism reliability was obtained by adhering to the 'what-if' perspective and desirability values of the top-ten optimum values of the dental workforce. Conclusion: The results of the study show that social and economic determinants play an important role in the estimated dental workforce planning assessment required for oral and dental health in Turkey.

Can you help develop a dental workforce in Liberia?

Can you help develop a dental workforce in Liberia?

Examining the Experiences of US Dentists during the First Wave of the COVID-19 Pandemic: Implications for Policy and Practice

(1) Background: As an emerging topic, no known study to date has described interviews with US dentists regarding their experiences during the beginning of the coronavirus disease 2019 (COVID-19) with regard to office closures and their implications for both the dentists and the patients they serve, especially among dentists in their first decade of work and new to practice ownership roles. Therefore, the purpose of this study was to describe the experiences of early-career US dentists during the initial stages of the COVID-19 pandemic. (2) Methods: This study utilized a semi-structured interview protocol and employed qualitative descriptive methodology. SPSS 26 and NVivo12 were utilized for data analysis. (3) Results: In April 2020, a total of 12 early-career US dentists completed the interview study protocol. The study sample majority was male (67%), with a mean age of 32 (range = 30–37) and an average of 6 years of dental practice experience (range = 5–10). Participants completed phone interviews with the research team. In summary, three organizing themes emerged: (1) Dentistry during COVID-19: Experiences during the first wave, (2) Long-term concerns regarding COVID-19, and (3) COVID-19 professional communication and dental research. (4) Conclusions: The chief findings of this study are dentists’ long-term concerns for the profession post-COVID-19. Research must still determine how to best prepare for future infectious disease outbreaks with regards to safeguarding the health of the dental workforce and maintaining the oral health of patient populations.

Status of Public Sector Dental Health-Care Services in Nellore District, Andhra Pradesh, India

Background and Objectives: Primary health centers (PHCs) are the foundation of rural health services in India. The nonavailability of reports on the status of dental care services at public health-care centers in rural Andhra Pradesh prompted us to describe the status of dental care services provided at public health-care centers in the Nellore district of Andhra Pradesh. Materials and Methods: This cross-sectional study was conducted using a semi-structured interview guide, based on the Indian Public Health Standards (IPHSs) guidelines. Data were collected on the dental health workforce, equipment, and facilities available, dental care services provided in all government dental care units, and dental care services provided by PHCs without dentists in the Nellore district, from dental and medical doctors, respectively. The descriptive statistics (frequencies) were performed describing the availability of workforce, equipment, and facilities, and the type of dental care services provided. Results: Of 95 public health-care centers in the Nellore district, only 18 centers provided dental care services. No single center was furnished with the prescribed dental health workforce, equipment, and facilities to render comprehensive dental care services to an optimum level according to IPHS guidelines. There were neither oral health promotional activities nor outreach programs targeting rural children, families, and communities carried out at these PHCs as per the IPHS guidelines. Conclusion: An inadequate dental health workforce, deficient dental equipment, and facilities, and very limited dental care services were found at these public health-care centers in the Nellore district, making these services almost nonexistent to rural populations.

Strengthening the oral health system in Nigeria: A health systems building block approach.

The present study aimed to describe the building blocks of the oral health system, including the role that the community plays in strengthening the oral health system in Nigeria. This research was a scoping review of the existing literature retrieved from search engines and databases. Thus, we utilised grey literature, peer-reviewed literature, policy documents and websites. The oral health system was analysed using the World Health Organisation's Health systems framework, and we adapted this framework by introducing a seventh block, community participation. We also inserted the links between the oral health service delivery and oral health workforce blocks of the framework to improve the oral health outcomes. More dental clinics are required to improve the availability and accessibility of oral health services. Dental workforce expansion is imperative. This can be approached by training of junior cadre dental professionals and incorporating community health practitioners to deliver basic oral care. There is an unregulated access to medication to treat dental conditions; hence, oral disease treatments need to be included in the country's treatment guidelines to improve standard of care. The government needs to improve on overall health spending and invariably increase oral health care allocation urgently. Furthermore, the country's stewardship of oral health care is hinged on well disseminated and implemented national policies on oral health. The oral health system can achieve its overall goals with community participation, engagement and ownership. Strengthening the oral health system in Nigeria requires urgent attention on each building block and cross-cutting interventions across the system's building blocks. The role of the community will need to be recognised because it is vital in sustaining any organisational change.

Creativity, confidence and the courage to change: the future dental workforce – part one

How can we improve infant and child dental health outcomes?

Dental education and prison health: A scoping review.

There is a huge oral disease burden among imprisoned people. Comprehensive guidelines are available on prison dentistry. Prison dental education is important to increase the quality and quantity of the dental workforce in prisons. It improves student perceptions about imprisoned people and gives students a sense of social responsibility and accountability. The aim of the scoping review was to determine what is known in the literature about teaching pre-doctoral dental students about prison health. A literature search was conducted on seven databases accessed through the Public Health England knowledge and library services. These databases were AMED, Embase, Emcare, Medline, Social Care Institute for Excellence, Web of Science, and Social Care Online. Appraisal of quality was done for included studies. Eleven papers were included in the review, all of which are based in the USA. Two articles looked at dental students as one group engaged in prison health education while five considered imprisoned people as one of the vulnerable populations focused on dental education. Only four articles solely looked at prison dental education. Program design with a collaborative approach between prisons and teaching institutions, and the positive impact of prison health education on dental students emerged as important. The evidence suggests prison dental education to be important in reducing the high burden of oral diseases among the incarcerated by influencing the present and future prison dental workforce. It also improves students' understanding of social determinants of health. Further studies are needed to determine the most effective teaching methods and models.

Assessing the Reason for Choosing Dentistry as a Career: A Survey Among First-Year Dental College Students

Career choice is a complex decision in our life. The opportunity to participate in dental education in many countries, especially in the developing ones, is limited to a small percentage of the community. Choosing dentistry as a career option may be due to various reasons, influences like economical status, financial status, social status, and many more. Students also try to make a career choice while studying itself. Meanwhile, choosing dentistry as a job should be accomplished with more precise considerations because changing this job is rarely possible. The changing nature of the dental workforce and the need to retain the services of future members has made it important to understand why current dental students have chosen dentistry as their career. However, the choice of dentistry becomes forceful at times by peer pressure, cultural thrust, or inability to procure medicine. Questions distributed through an online survey were answered by the participants and the results are collected and analyzed statistically. From the results obtained and analyzed the various reasons for choosing dentistry as a carrier was understood. The main reason for choosing dentistry as a career is because majority (42.97%) missed MBBS as their first career choice.

Comparison of Dental Care Visits Before and After Adoption of a Policy to Expand the Dental Workforce in Minnesota

Currently, 13 states and tribal nations have expanded their dental workforce by adopting use of dental therapists. To date, there has been no evaluation of the influence of this policy on dental care use. To assess changes in dental care use in Minnesota after the implementation of the policy to authorize dental therapists in 2009. In this cross-sectional study of 2 613 716 adults aged 18 years and older, a synthetic control method was used to compare changes in dental care use after the authorization of the policy in Minnesota relative to a synthetic control of nonadopting states. Data from the Behavioral Risk Factor Surveillance System from 2006 to 2018 were analyzed. Data analysis was conducted from June 1, 2021, to December 18, 2021. Authorization of dental therapy. Self-reported indicator for whether a respondent had visited a dentist or a dental clinic in the past 12 months. Among 2 613 716 adults aged 18 years or older, the mean (SD) age at baseline was 46.0 (17.7) years, 396 501 were women (weighted percentage, 51.3%), 503 197 were White (weighted percentage, 67.9%), 54 568 were Black (weighted percentage, 10.1%), 39 282 were Hispanic (weighted percentage, 14.5%), and 34 739 were other race (weighted percentage, 6.7%). The proportion of adults visiting a dentist before the authorization of dental therapists in Minnesota was 76.2% (95% CI, 75.0%-77.4%) in the full sample, 61.5% (95% CI, 58.4%-64.6%) for low-income adults, and 58.4% (95% CI, 53.0%-63.5%) among Medicaid-eligible adults. Authorizing dental therapists in Minnesota was associated with an increase of 7.3 percentage points (95% CI, 5.0-9.5 percentage points) in dental care use among low-income adults, a relative increase of 12.5% (95% CI, 8.6%-16.4%), and an increase of 6.2 percentage points (95% CI, 2.4-10.0 percentage points) among Medicaid-eligible adults, a relative increase of 10.5% (95% CI, 3.9%-17.0%). In addition, the policy was associated with an increase in dental visits among White adults (low-income sample, 10.8 percentage points [95% CI, 8.5-13.0 percentage points]; Medicaid sample, 13.5 percentage points [95% CI, 9.1-17.9 percentage points]), with no corresponding increases among other racial and ethnic groups in the low-income and Medicaid population. In this cross-sectional study, expanding the dental workforce through authorization of dental therapists appeared to be associated with an increase in dental visits. In Minnesota, the policy was associated with improved access to dental care among low-income adults overall. However, racial and ethnic disparities in dental use persist.

Assessing the Effectiveness of Web-Based Modules on Human Papillomavirus Among Dental and Dental Hygiene Students.

Literature suggests that deficiencies among dental professional students in both knowledge and awareness of human papillomavirus (HPV) and its association with oropharyngeal cancers (OPC), as well as its risk factors implicating the prevalence of HPV, may be due to the lack of HPV-related education during professional schooling. The aim of this study was to assess the effectiveness of an online learning tool to educate dental and dental hygiene students about HPV and its association with OPC, rapidly evolving disease patterns, and dental professionals’ role in HPV-associated OPC prevention efforts. A three-section online learning module was developed to improve dental professionals’ comfort levels with, and knowledge of, HPV. The participants were recruited to participate in surveys before and after the intervention. Descriptive statistics and chi-square analysis were computed to study the effectiveness of the modules in improving the knowledge of students about this topic. Pre-intervention survey participants totaled 142, and 107 participants answered the post-intervention survey. The majority of the study participants had some baseline understanding of HPV prior to accessing the modules. After reviewing the modules, there was a statistically significant increase in the proportion of respondents who identified OPC (p = 0.01), vaginal cancer (0.02), vulvar cancer (0.04), and penile cancer (0.01) as associated with HPV. A gap in the understanding of HPV vaccine–eligible groups was noted in almost half of the participants; while most participants could correctly identify that boys and girls aged 9–12 years were eligible to get the vaccine, the gap in knowledge in this regard was related to “25-year-old with an abnormal pap result.” Due to the evolving nature of this topic, there is a need to find new and effective methods of disseminating HPV-related information among the existing and future dental workforce.

Potential educational and workforce strategies to meet the oral health challenges of an increasingly older population: a qualitative study

IntroductionThe demographic shift in the age profile of the UK is well established. Older people have more complex requirements to maintain their oral health.ObjectivesThis research explored Gerodontology with influential and recognised UK experts in Dental Public Health, Dental Education and Gerodontology. Three main topics were explored: the dental challenges associated with the ageing population, the role of dental care professionals (DCPs) and the training of undergraduate dental professionals.MethodsQuantitative data from the literature were used to develop a topic guide for semi-structured interviews with a purposeful sample of nine participants. Initial analysis of the qualitative data was undertaken using NVivo V12 software and themes were identified. Final themes and subthemes were confirmed after a series of remote round table discussions.ResultsFour themes and 14 subthemes were identified. These included disagreements and agreements, the challenges of providing dental care to the older adult population, and the delivery of dental care by the dental team and finally education. All participants had significant concerns about the oral and dental challenges of the older population.ConclusionsThe themes that emerged were complex and overlapping. Better utilisation of all members of the dental workforce was reported to be an essential approach, as was reorientation of existing care models with a focus on prevention. Regarding undergraduate education, the consensus was that the training was not adequate for both current and future needs.

The dental workforce: An assessment of the recruitment market

The dental workforce: An assessment of the recruitment market

Dental hygienists' scope of practice regulations and preventable non-traumatic dental emergency department visits: A cross-sectional study of 10 U.S. states.

As emergency department (ED) visits for non-traumatic dental complaints continue to rise in the United States (U.S.), some states are implementing initiatives to expand access to the oral health workforce. This study examines the associations between the 2014 Dental Hygiene Professional Practice Index (DHPPI) and preventable dental ED visits. In 2020, we used ED data from 10 U.S. states and ordinary least squares models to examine the relationship between the states' DHPPI scores and preventable dental ED use.We stratified regressions by age to examine this relationship across different age cohorts and introduced interaction terms to assess the same relationship among rural and urban residents. On average, 23.8% of all non-traumatic dental ED visits were identified as preventable. Controlling for other factors, a one-point increase in DHPPI scores was associated with a decrease of 0.01 (95% CI -0.03, -0.02) preventable dental ED visits per 1000 county population in each year-quarter. In the age-stratified models, the strength of the association between DHPPI scores and preventable dental ED visits was higher in the 20 to 34 (-0.03, 95% CI -0.04, -0.02), and the 35 to 50 age cohorts (-0.17, 95% CI -0.00, -0.00). U.S. states with DHPPI scores below 60saw significantly higher preventable dental ED visits among rural residents. This studydemonstratesthat stringent state policiesregarding the dental hygienist workforce are associated with higher preventable dental ED visits in the U.S. Policy makers and stake holders must address the scope of practice policies to alleviate the burden of access to oral healthcare.

The dental workforce in Libya: an overlooked research topic

EDITORIAL