title: Workforce skill mix: modelling the potential for dental therapists in state-funded primary dental care.
abstract: BACKGROUND
  South Central Strategic Health Authority [SHA], with a population of four million, is one of 10 regions of England with responsibility for workforce planning.
  
  
  OBJECTIVE
  To explore future scenarios for the use of the skill mix within the dental team to inform the commissioning of dental therapy training.
  
  
  METHODS
  Data on population demography, oral health needs and demands, dental workforce, activity and dental utilisation were used to create demand (needs-informed) and supply models. Population trends and changing oral health needs and dental service uptake were included in the demand model. Linear programming was used to obtain the optimal make-up of the dental team. Based on the optimal scenario, workforce volumes and costs were examined across a range of scenarios up to 2013.
  
  
  RESULTS
  Baseline levels of dental therapists were low and estimated as only achieving 10-20% of the current potential job competency. The optimal exploratory scenario in terms of costs and volume of staff was based on dental therapists working full time and providing 70% of routine care that is within their current job competency; this scenario required 483 therapists by 2013, a figure that appeared achievable. Increasing the level of job competency provided by therapists revealed potentially higher benefits in terms of reduced cost and requiring fewer dentists.
  
  
  CONCLUSIONS
  The findings suggest that dental therapists can play a more significant role in the provision of primary dental care, both currently and in future; they also highlight the need for health services to routinely collect data that can inform workforce analysis and planning.
authors.affiliation: King's College, London, UK. jenny.gallagher@kcl.ac.uk
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Gallagher
authors.forename: Zhenlui
authors.initials: Z
authors.lastname: Lim
authors.forename: Paul R
authors.initials: PR
authors.lastname: Harper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002391:Catchment Area, Health; D002648:Child; D002675:Child, Preschool; D003363:Cost Control; D003727:Dental Auxiliaries / Q000706:statistics & numerical data / Q000600:supply & distribution; D003815:Dentists / Q000706:statistics & numerical data / Q000600:supply & distribution; D004739:England; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D016014:Linear Models; D008875:Middle Aged; D008962:Models, Theoretical; D009909:Oral Health; D010348:Patient Care Team; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data; D013218:State Dentistry / Q000191:economics / Q000706:statistics & numerical data; D055815:Young Adult
references.citation: Br Dent J. 2007 Feb 10;202(3):E8; discussion 146-7
references.pmid: 17256012
references.citation: Br Dent J. 2011 Aug 12;211(3):E6
references.pmid: 21836552
references.citation: Br Dent J. 2003 Jan 11;194(1):37-41
references.pmid: 12540938
references.citation: J Dent Educ. 2009 Aug;73(8):1001-8
references.pmid: 19648571
references.citation: Gerodontology. 2009 Sep;26(3):193-201
references.pmid: 19545327
references.citation: Br Dent J. 2010 Feb 13;208(3):E6; discussion 116-7
references.pmid: 20134480
references.citation: Br Dent J. 2004 Oct 23;197(8):491-6; discussion 477
references.pmid: 15547610
references.citation: Br Dent J. 2011 Apr 9;210(7):303-8
references.pmid: 21475274
references.citation: Int J Dent Hyg. 2009 May;7(2):108-14
references.pmid: 19416093
references.citation: Br Dent J. 2011 May 28;210(10):E16
references.pmid: 21617648
references.citation: SADJ. 2007 Sep;62(8):360, 362-4
references.pmid: 18019123
references.citation: Aust Dent J. 2004 Dec;49(4):162-70
references.pmid: 15762336
references.citation: Br Dent J. 2011 Feb 26;210(4):E5
references.pmid: 21293494
references.citation: Br Dent J. 2000 Oct 28;189(8):435-8
references.pmid: 11093392
references.citation: Br Dent J. 2001 Jan 13;190(1):3
references.pmid: 11235973
references.citation: Int Dent J. 2007 Aug;57(4):267-73
references.pmid: 17849686
references.citation: Ghana Med J. 2006;40(4):118-26
references.pmid: 17496985
references.citation: BMC Health Serv Res. 2006 Mar 14;6:32
references.pmid: 16536870
references.citation: Br Dent J. 2011 Feb 26;210(4):166-7
references.pmid: 21350530
references.citation: Hum Resour Health. 2009 Dec 19;7:87
references.pmid: 20021682
references.citation: Int Dent J. 2008 Apr;58(2):61-70
references.pmid: 18478885