title: Mapping the Quebec dental workforce: ranking rural oral health disparities.
abstract: BACKGROUND
  Ensuring access to oral health services is crucial for improving the oral health of rural and remote populations. A logical step towards addressing oral health disparities and underutilization of services in rural areas is to ensure the availability of the dental workforce. Geographical information systems are valuable in examining workforce dispersion patterns and identifying priority areas requiring administrative and policy attention. The objective of this study was to examine and map the distribution patterns of the dental workforce in Quebec, Canada.
  
  
  METHODS
  Utilizing the membership directory of Quebec Professional Orders (2009-2010), data on practice locations, practice types and license issue date for all active members of the Quebec dental workforce were obtained. This was followed by reverse geocoding of the geographic coordinates using a global positioning system visualizer to reveal textual locations. These locations were classified according to various degrees of rurality as defined by the 2006 Census Metropolitan Area and Census Agglomeration Influenced Zone typology, developed by Statistics Canada. Cartography layers were extracted from a geospatial database provided by Canada Natural Resources using ArcGIS 9.3. Descriptive and bivariate analyses were performed using SPSS v17 for Windows.
  
  
  RESULTS
  Data analysis revealed statistically significant differences in the distribution of dental professionals in rural and urban areas (urban 59.4±19.4/100 000 vs rural 39.9±17.6/100 000; p<0.001). Approximately 90.3% of the dental workforce was located in urban zones, 1.3% in the zones strongly influenced by metropolitan area, 4.9% in the moderately influenced zones, while only 0.3% of the dental workforce was located in non-metropolitan-influenced zones. Urban zones such as Montreal, Quebec and Sherbrooke had the highest workforce availability (4-6 dentists for every 5000 inhabitants). Of a total of 447 specialist dentists in Quebec, only five were located in rural areas.
  
  
  CONCLUSIONS
  This study concludes that there is a strong relationship between the degree of urbanization and the highest concentration of dental professionals. In addition, there is a lack of dental workforce availability, particularly specialists in rural Quebec. Further research is needed to examine and evaluate to what degree these distribution patterns might contribute to oral health outcomes of the rural population.
authors.affiliation: Faculty of Dentistry & School of Public Health, Université de Montréal, Montréal, Québec, Canada. elham.emami@umontreal.ca.
authors.forename: Elham
authors.initials: E
authors.lastname: Emami
authors.affiliation: Oral Health and Rehabilitation Research Unit, Biomedical Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada. muhammad.faheem.khiyani@umontreal.ca.
authors.forename: Muhammad Faheem
authors.initials: MF
authors.lastname: Khiyani
authors.affiliation: Université de Montréal, Montréal, Québec, Canada. carl.patrick.habra@umontreal.ca.
authors.forename: Carl Patrick
authors.initials: CP
authors.lastname: Habra
authors.affiliation: Oral Health and Rehabilitation Research Unit, Université de Montréal, Montréal, Québec, Canada. v.chasse@umontreal.ca.
authors.forename: Véronique
authors.initials: V
authors.lastname: Chassé
authors.affiliation: Department of Stomatology, Faculty of Dentistry, Université de Montréal, Montreal, Canada. pierre.rompre@umontreal.ca.
authors.forename: Pierre H
authors.initials: PH
authors.lastname: Rompré
mesh_terms: D003753:Dental Health Surveys / Q000706:statistics & numerical data; D005792:General Practice, Dental / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D009909:Oral Health / Q000706:statistics & numerical data; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D011792:Quebec; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population / Q000706:statistics & numerical data*; D019037:Urban Health Services / Q000458:organization & administration; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Clinical Trials; Dentistry; North America; Randomised Controlled Trials