How many dentists does it take to…?

How many dentists does it take to…?

Dr Chris Sanzaro, ADA (Tas) President.

Dental workforce in Tasmania and Australia

• Dental & oral diseases – what do we do?

• Scope of practice – who does what for whom?

• Dental education – who trains whom?

• Workforce predictions – how many do we need?

Dental & oral diseases

• Dental caries and tooth loss

• Periodontal disease and tooth loss

• Oral mucosal lesions and neoplasias

Dental caries and tooth loss

• Despite water fluoridation, & other preventive measures caries is still prevalent.

• Tooth loss

Periodontal diseases• “Gum disease”• Tooth loss

Oral mucosal lesions and neoplasias

Scope of practiceWhat do we have in Tasmania?

• Dentist– Specialists in Tasmania

• Endodontists• Periodontists• Orthodontists• Paedodontists• Oral & Maxillofacial Surgeons

– Specialists not in Tasmania• Prosthodontists• Oral Pathologists• Dento-maxillofacial radiologists• Forensic odontologists• Oral Medicine specialists• Special Needs Dentists

Dental AuxilliariesWhat do we have in Tasmania?

• Dental Hygienist• Dental Therapist• Oral Health Therapist• Dental Prosthetist

Dental Education Universities

• Role of universities

• Businesses?• Knowledge transfer?• Education & Research?

Dental Education Universities

• Demand driven places• Increase in graduates

2007

2008

2009

2010

2011

2012

2013

2014

193 349 469 428 428 478 581*

>620*

Award Course Completions, Department of Innovation 2007–2012. *Data from 2013 provided by Australasian Council of Dental Schools

Dental Education Overseas - ADC

• ADC examination• Immigration

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 201351 52 37 48 61 110 158 156 171 204 242 215 263 230

Dental Auxilliaries

Registration category 2006 2009 2012 Dec 2013*

Dental hygienist 784 1067 1216 1258

Dental therapist 1380 1412 1162 1095

Dental hygienist and dental therapist

N/A N/A 514 487

Oral health therapist 410 663 614 920

Total 2574 3142 3506 3760

Allied dental practitioners registration dataSource: AIHW Dental Workforce 2012 and *DBA

The basic numbers

• Need 510 new dentists per year– Retirement– Population growth

• Graduates and migrants 930 per year

• Already have an oversupply– New grads unemployed &

underemployed– Practical experience is lost

Workforce projections

• Health Workforce Australia– Report – not yet published

• Calls it “Underutilisation”• Lost in the change of government and

disbanding of HWA

• Oversupply until at least 2025– No-one has looked beyond 2025

Previous undersupply or a maldistribution?

• Metropolitan vs regional / rural• Elective / cosmetic treatment vs

basic health• Changed spending patterns• Tasmanian experience

Recent Changes

• Australia Wide– Less job vacancies– Size of town vs sustainability of practice

• Tasmania– Anecdotal evidence of significant changes– Less job vacancies– Most surgeries are fully staffed– Emergency appointment availability– Several new specialists, better availability

Who pays for dentistry?

Access

• Surveys show 1/3 of Australians don’t access dental care due to cost

• Public dental scheme:– HCC / PCC holders

• Private Dentists– Increased access to appointments over

last 5 years in Tas.

• ADA’s “Dental Access”

Action required

• Funding – Dental Access• Limit dental student places at

Universities• Remove dentistry from TTMR• Remove Dentists from the Skilled

Occupation List

Where are our dental students heading?

Thankyou

Dr Chris Sanzarochris@sanzaro.comada@tassie.net.au