Dental

Statistical Publication Notice

25 September 2008

An Analysis of Dental Workforce in Scotland, Statistical Report 2008

INTRODUCTION

• A review of recent trends in oral health in Scotland (Section 2) provides the background to the report by describing the latest trends in children's and adults' oral health.
• The supply of dentists in Scotland (Section 3) describes recent trends in the stock and flow of dentists in NHSScotland and considers a number of factors that are likely to drive the supply of NHS dentists in the future.
• The utilisation of dental services in Scotland (Section 4) examines the utilisation of NHS and private sector dental services.
• Forecasting the dental workforce (Section 5) considers several different supply and demand forecasts, including updated versions of the models in NES (2004) and NES (2006):
  • the supply forecasts provide an indication of the variation associated with different approaches to forecasting and allow the accuracy of these forecasts to be compared; and
  • the demand forecasts reflect the workforce implications of a range of measures, including several targets set out in the Dental Action Plan Monitoring forms used by NHS Boards.
• Avenues for future research (Section 6) sets out an agenda of research to further improve the information available to the dental workforce project.

KEY POINTS

• Children's oral health in Scotland has improved during the past 30 years, but this improvement slowed during the 1990s. While there has been some improvement more recently, many Scottish children still suffer from tooth decay and have begun "a journey of deteriorating oral health" to adulthood. Greater deprivation is associated with poorer oral health so there remains a considerable challenge to improve the oral health of children from deprived communities. While Scotland?s children still have among the highest levels of decay in the United Kingdom, the significant investment in national oral health programmes represents a unique and major effort to tackle this problem.
• The oral health of adults in Scotland has improved markedly during the past 30 years. If this trend continues, there will be fewer adults with no natural teeth and more adults retaining more teeth into their older years. While there is a data deficit in that recent and detailed oral health data on adults in Scotland is not available, steps are being taken to ensure that these data are collected and will be available in the future.
• There is some evidence of a positive association between oral health and utilisation of dental services. However, there are a number of plausible explanations for this association: an increase in oral health might cause an increase in utilisation; an increase in utilisation might cause an increase in oral health; or changes in other factors, such as income or preferences for oral health, might cause both utilisation and oral health to increase. Identifying the correct explanation remains a key area for future research. Furthermore, it is important to build a more detailed picture of oral health and the association between need, demand and utilisation of dental services.
• The workforce implications of this general improvement in the oral health of both children and adults are not clear and it is difficult to obtain robust evidence on the overall effects of this trend. The indicators seem to point to increasing demand, with significant unmet need, particularly in our most deprived communities.

The supply of dentists in Scotland

• The number of NHS dentists working in NHSScotland increased by over 25% between 1996 and 2007. Since 2005, this increase has accelerated and is accounted for by the inflow of dentists from Vocational Trainees and, to a much larger extent, by the inflow of dentists without any previous experience in NHSScotland.
• A number of indicators, from the expected number of graduates to the retention rates of VTs in NHSScotland, suggest that there is likely to be a relatively large and sustained increase in the stock of NHS dentists in Scotland in the future.

• Between 2000 and 2008 children's registration rates were constant but adults' registration rates decreased steadily. In 2008, both children's and adults' registration rates increased. At least in part, this increase is likely to be a result of the extension to the registration period.
• A much greater percentage of the adult population, about 79%, has accessed NHS dental care over nine years than is suggested by NHS registration rates. This is because a large number of individuals access the NHS General Dental Service (GDS) but do so relatively infrequently.
• At national level, there has been little change in the number of claims made by GDS dentists but there are some areas where the number of GDS claims has increased and others where it has decreased.
• Both the British Household Panel Survey (BHPS) and Denplan data show that the private sector continues to grow. These data also show that the private sector attracts patients with higher incomes, relatively good oral health and low future dental care needs. The extent of private sector penetration varies across Scotland.
• Understanding the impact of the recent increases in the supply of dentists on the market for dental services is a key area of future research.

• There are several different methods of forecasting the supply of dentists. All the forecasts show that, based on the current evidence of the inflow and outflow of NHS GDPs in Scotland, there is likely to be a relatively large and sustained increase in the stock of NHS dentists in Scotland in the future.
• In the past two years, relatively simple forecasting approaches have outperformed more sophisticated methods.
• There are several different ways of measuring the demand for dentists. Most of the forecasts implied by these different measures suggest there is likely to be an increase in the demand for dentists in the future mainly as a result of the expected increase in Scotland's population.
• The extent to which excess demand or supply is forecast depends crucially upon how the demand for dentists is measured and the method used to forecast supply.

MAIN CONTACTS:

Dariusz Blaszczak
Information Analyst
0131 275 6859

Stephen Goold
Dental Information Programme Manager
Tel: 0131 275 6316

Colin Tilley
Educational Projects Manager
NHS Education for Scotland

David Conway
Senior Clinical Lecturer / Consultant in Dental Public Health University of Glasgow / NHS National Services Scotland

PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:

This is a non-National Statistics publication, and is a collaborative study published by NHS Education for Scotland (NES) and the Information Services Division of NHSScotland (ISD).

Preview access has been given to NES, ISD, Scottish Government, National Workforce Planning Unit and the British Dental Association.

HISTORY OF THIS PUBLICATION:

Last Published: June 2006
Data Avaliable Since: February 2002

Main contact: Stephen Goold

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