A Comparison for Estimates of Dental Manpower Needs to Treat All Thai Schoolchildren aged 6 to 12 years old Using Two Approaches: Normative and Sociodental Approaches
Objective: The objective of this study was to compare the number of dentists needed by the year 2030 to treat dental diseases in the Thai schoolchildren population, estimated by the traditional normative dental health need method and the number estimated using two adjusted health need models, based on the sociodental approach and the annual estimated increment of dental caries.
Materials and Methods: The oral health status of 1,211 students aged 6 and 12 years from five selected provinces were examined using dental survey methods recommended by the WHO. Normative treatment needs were assessed by dentists who conducted the examinations. In addition, a sociodental approach comprising impact-related need and propensity-related need of students was used, incorporating the Oral Impact on Daily Performance (OIDP) index and interviews. Estimation of the number of dentists required in the year 2030 was carried out using the examination data, the predicted number of schoolchildren in the year 2030 and models based on (1) the entire normative need alone, (2) the entire normative need incorporated with the sociodental approach, and (3) the annual incremental normative need incorporated with the sociodental approach.
Results: The manpower need in Model 1, the model based on the entire normative need alone was 5,874 dentists. The three scenarios based on the entire normative need incorporated with the sociodental approach produced requirements of 4,994, for Scenario 1 (areas with a DMFT 0.2 to 1.8), 5,521 for Scenario 2 (areas with a DMFT 0.5 to 2.2) and 5,950 dentists for Scenario 3 (areas with a DMFT 0.8 to 3.1), respectively. The Model 3 incorporating incremental need and not normative need with the sociodental approach produced a manpower requirement of 1,418 dentists. The calculation based on normative needs alone yielded the highest estimates. Incorporating the sociodental approach with the entire normative need decreased the estimates for areas with a low and medium DMFT. Estimating dentist requirements by using the yearly incremental increase in normative needs incorporated with the sociodental approach estimated the number of dentists required to deal with new increments of caries was one fourth of those calculated by using normative need alone.
Conclusions: As proposed by this study,
adjusted dental treatment needs method should
be used to calculate dental manpower needs
based on the annual incremental increase in
dental disease instead of using overall dental
disease in the manpower calculation process.
1. Joint WHO/FDI Working Group. Health through oral health-Guideline for Planning and Monitoring Oral Health Care. London: Quintessence Publishing Company Ltd; 1989.
2. Khan AA, Sithole WD. Oral health manpower projection methods and their implications for developing countries: the case of Zimbabwe. Bull World Health Organ 1991; 69(3): 339-346.
3. Holler, I. and Machans, N. Concept of Dental Health for All in the Year 2000. World Health Organization. Cited in Office of the Permanent Secretary, Ministry of University Affairs. Report on Increase Production of Dental Graduates by Ministry of University Affairs to the Cabinet. Bangkok: Chulalongkorn University Press; 1989. (in Thai)
4. Hornby P, Ray D, Shipp P, Hall T. Guidelines for health manpower planning. Geneva: World Health Organisation; 1980.
5. Hall TL. Demand; In Hall TL and Mejia A ed. Health Manpower Planning: Principles, Methods, Issues, Geneva: World Health Organization, 1978.
6. Dental Public Health Division, Department of Health, Ministry of Public Health. Dental manpower development to achieve oral health for all by the year 2000. Bangkok; 1986.
7. Dental Faculty Consortium of Thailand. Dental personnel in dental public health system in Thailand. Khonkaen: 1993.
8. Ministry of Public Health, Working Group on Studying and Reviewing Medical and Public Health Manpower, Dental Health Group. Estimation of Dental Health Manpower in the Next 10 Years (2008-2017). Bangkok; 2009.
9. Yuktanand, I. Dental Public Health in Thailand. Thesis. National Defense College, 1972. (in Thai)
10. Tumkhosit, U. Estimation of need for dental personnel, In: Workshop proceedings on Projection of Supply and Requirement of Dental Health Manpower in the Next 10 Years. August 1-4, 1978, Railway Hotel, Hua Hin; 1978 (in Thai)
11. Udompanich S. The development of delivery care model in dental public health at district level. Ph.D. Mahidol University, 1990
12. Sheiham A, Tsakos G. Oral health needs assessment. In: Pine CM and Harris R eds: Community Oral Health. London: Quintessence Books; 2007: 59-79.
13. Bourgeois D, Leclercq MH, Barmes DE, Dieudonn? B. The application of the theoretical model WHO/FDI planning system to an industrialised country: France. Int Dent J 1993; 43(1): 50-58.
14. Morgan MV, Wright FA, Lawrence AJ. Laslett AM. Workforce predictions: a situational analysis and critique of the World Health Organisation model. Int Dent J 1994; 44(1): 27-32.
15. Gherunpong S, Tsakos G, Sheiham A. A sociodental approach to assessing children’s orthodontic needs. Eur J Orthod 2006; 28(4): 393-39.
16. Schou L. The relevance of behavioural sciences in dental practice. Int Dent J 2000; Suppl: 324-332.
17. Adulyanon, S. An integrated socio-dental approach to dental treatment need estimation. Ph.D., University of London, 1992.
18. Srisilapanan P, Sheiham A. Assessing the difference between sociodental and normative approaches to assessing prosthetic dental treatment needs in dentate older people. Gerodontology 2001; 18(1): 25-34.
19. Tsakos G, Gherunpong S, Sheiham A. Can oral health-related quality of life measures substitute for normative needs assessments in 11 to 12-year-old children? J Public Health Dent 2006; 66(4): 263-268.
20. Ryu JI, Tsakos G, Sheiham A. Differences in prosthodontic treatment needs assessments between the standard normative and sociodental approach. Int J Prosthodont 2008; 21(5): 425-432.
21. World Health Organization. Oral Health Surveys: Basic Methods-4th edition. Geneva: World Health Organization, 1997.
22. Gherunpong S, Tsakos G, Sheiham A.
Developing and evaluating an oral healthrelated quality of life index for children; the
CHILD-OIDP. Community Dent Health 2004;
21(2): 161-169.
23. Gherunpong S, Tsakos G, Sheiham A. A sociodental approach to assessing dental needs of children: concept and models. Int J Paediatr Dent 2006; 16(2): 81-88.
24. Maizels J, Maizels A, Sheiham A. Sociodental approach to the identification of dental treatment-need groups. Community Dent Oral Epidemiol 1993; 21(6): 340-346.
25. Dental Public Health Division, Department of Health, Ministry of Public Health. Report on the 6th Thailand National Oral Health Survey, Nonthaburi: 2008.
26. Dental Public Health Division, Department of Health, Ministry of Public Health. Report on Provincial Oral Health Survey 1983-1998, Nonthaburi: 2000.
27. Dental Public Health Division, Department of Health, Ministry of Public Health. Report on the 5th Thailand National Oral Health Survey, Nonthaburi: 2002.
28. Vichawut K, Pholdeeyiam S, Lexomboon D, Wongkhongkathep S, Busarakamruha J, Sukhanwaranit S. Dental personnel situation in Thailand health service system. Nonthaburi: 2005.
29. Srisilapanan P, Korwanich N, Sheiham A. Assessing prosthodontic dental treatment needs in older adults in Thailand: normative vs. sociodental approaches. Spec Care Dentist 2003; 23(4): 131-134.