specialities, accredited by the Australian Dental Coun- cil.2 These include: orthodontics, oral and maxillofacial surgery, prosthodontics, periodontics ...
Australian Dental Journal 2010; 55: 96–100
DATA WATCH
doi: 10.1111/j.1834-7819.2009.01189.x
Dental specialists in Australia Australian Research Centre for Population Oral Health, The University of Adelaide, South Australia. INTRODUCTION Dental specialists play a key role in maintaining clinical excellence and in providing leadership. According to Spencer et al., specialists provide exceptional services to ‘special’ patients, serving as a focal point for raising the quality of dental care, innovation and adoption of new procedures, clinical research and continuing education of general dental practitioners.1 In Australia, education and training is offered in 12 specialities, accredited by the Australian Dental Council.2 These include: orthodontics, oral and maxillofacial surgery, prosthodontics, periodontics, endodontics, paediatric dentistry, oral pathology, oral medicine, oral pathology and oral medicine, public health dentistry, dento-maxillofacial radiology, and special needs dentistry.2 Specialist training is offered by six dental schools throughout Australia,a but not all of these schools offer training programmes for all specialities.3 The training generally involves an additional three years of postgraduate education leading to specialist registration. Oral and maxillofacial surgery training is offered as a fellowship through the Royal Australian College of Dental Surgeons and requires completion of a medical degree.2 Monitoring and surveillance of dental specialists is important as it can inform decisions related to specialist training and improving the geographic reach of specialists, especially in supporting primary care.4,5 This article presents a cross-sectional view of the 2006 dental specialist labour force in Australia and attempts to distinguish the key characteristics between specialist groups and between specialist and general practitioners.
The scope of the data collection included all registered practitioners. Data items collected form part of a data set agreed by the Australian Health Ministers’ Advisory Council. Items include information on demographic characteristics, practice status, practice type and hours worked. Dentists and specialists were asked to base their practice activity responses on their last week of work. Eight specialist categories were collected (orthodontics, periodontics, prosthodontics, dentomaxillofacial radiology, oral and maxillofacial surgery, endodontics, paediatric dentistry and oral pathology). Speciality groups not listed were categorized as ‘Other’.b Previous labour force reports have estimated specialist numbers using responses to area of practice and type of speciality.7–9 Estimates for 2006 have been derived from the speciality type question only. Estimates for earlier collections have been recalculated to be consistent with 2006 estimates and hence may differ slightly from previous publications. The overall response rate for the survey was 79.6%. Response rates varied by state and territory, ranging from 33.1% in the Australian Capital Territory to 90.7% in New South Wales.c Estimates reported have been weighted for nonresponses. Additional estimation for partially completed survey forms was based on the assumption that non-respondents had similar characteristics as respondents. Caution is advised when interpreting data from states ⁄ territories that have low response rates or small numbers. RESULTS
METHODS
Overall numbers
Data for this article were from the 2006 National Dental Labour Force Data Collection.6 These data are routinely collected annually by the Australian Institute of Health and Welfare’s Dental Statistics and Research Unit (AIHW DSRU) with the assistance of the state and territory health departments and dental boards.7–9
In 2006, there were an estimated 1502 registered dental specialists in Australia, comprising 12.3% of all dental registrations. Multi-state specialist registrations comprised 8%. Only small numbers were not working
a
The Universities of Melbourne, Sydney, Queensland, Adelaide, Western Australia and Griffith offer specialist training programmes in Australia. 96
b
The ‘Other’ category mostly included public health dentistry, special needs dentistry and geriatric dentistry. c Response rates: Vic (77.0%), Qld (73.8%), WA (67.5%), SA (86.9%), Tas (62.2%) and NT (49.5%). ª 2010 Australian Dental Association
Dental specialists in Australia Other
51
Dento-maxillofacial radiology
Other FTE rate
9
Practising rate
Paediatric dentistry 11
Paediatric dentistry
Endodontics
100
Endodontics
Speciality
Speciality
Oral pathology
116
Periodontics
146
Prosthodontics
Oral and maxillofacial surgery Prosthodontics
171
Periodontics Oral and maxillofacial surgery
206
Orthodontics
Orthodontics
518 0
100
200
300
400
500
0
600
Fig 1. Number of practising dental specialists, 2006.
(0.5%) or retired (0.7%). Small percentages were on extended leave or reported that they were looking for work (1.5% and 0.2%, respectively). An estimated 1328 specialists (88.4%) were practising, comprising 12.8% of all practising dentists (10 404). Nearly all practising specialists (92.1%) reported working in clinical practice in their main practice location, and 3.6% were involved in teaching and research. Overall, there were 6.4 practising specialists per 100 000 population in Australia, and 7.4 full-time equivalent specialists.d Orthodontists were the largest speciality group (n = 518, 39%), followed by oral and maxillofacial surgeons (n = 206, 15.5%), prosthodontists (n = 171, 12.9%), periodontists (n = 146, 10.9%), endodontists (n = 116, 8.7%) and paediatric dentists (n = 100, 7.6%) (Fig 1). Oral pathologists, dentomaxillofacial radiologists and ‘Other’ specialists comprised only 5.3% of the specialist labour force (Fig 1). The rate of practising orthodontists was the highest among all specialist groups (2.5 per 100 000 population) (Fig 2).
d
Full-time equivalent specialists per 100 000 population is calculated by multiplying the number of practising specialists by the average weekly hours worked and then dividing by a reference week (35 hours per week). ª 2010 Australian Dental Association
3
4
2. Full-time equivalent specialists per 100,000 population was calculated by multiplying the number of practising specialists bythe average weekly hours worked and then dividing by a reference week (35 hours per week). This value was then population standardised to allow comparisons with other states/territories. 3. Population data were based on the information available from the Australian Bureau of Statistics, 2006.
Fig 2. Number of practising specialists per 100 000 population and full-time equivalent (FTE) rate by speciality group, 2006.
General Practitioners Other Paedodontics Endodontics Oral and maxillofacial surgery Prosthodontics Peridontics Orthodontics 0
10
20
30
40
50
60
70
Practising specialists per 100,000 population Note: Due to small numbers in dento-maxillofacial radiology and oral pathology – specialists in these two groups were combined together into ‘Other’, along with Public health dentistry, Special needs dentistry and Geriatric dentistry.
Fig 3. Percentage female, general practitioners and specialists, 2006.
Demographic characteristics
35
Percentage of practitioners
The large majority of practising specialists were male (84.5%). In contrast, males comprised only 69.4% of the general practitioner labour force. With the exception of paediatric dentistry, the majority of practitioners in all specialities were male (Fig 3). The average age of specialist practitioners was 49.1 years, compared to 44.5 years in the general practitioner group. Approximately 45% of specialists were 50 years of age or older. One-third (31.1%) were between 40–49 years and 18.7% were between
2
Notes: 1. Due to small numbers in Dento-maxillofacial radiology and Oral pathology – specialists in these two groups were combined together into ‘Other’, along with Public health dentistry, Special needs dentistry and Geriatric dentistry.
Speciality
Note: ‘Other’ included Public health dentistry, Geriatric dentistry and Special needs dentistry.
1
Practising specialists per 100,000 population
Number of practising dental specialists
30 25 20 15 10 5 0
