title: Changes in division of labour and tasks within public dentistry: relationship to employees work demands, health and work ability.
abstract: OBJECTIVE
  By 2023, fewer dentists are expected in Sweden, at the same time as the demand for dental care is expected to increase. Older people, in particular, are expected to require more dental health than previous generations. To meet this demand, the public sector dentistry in Sweden is moving towards changes in division of labour among dental professionals, including dentists, dental hygienists and dental nurses. However, the impact of this reallocation on the physical and psychosocial wellbeing of employees is unknown. The aim of this study was to compare workplaces with an equal or larger proportion of dental hygienists than dentists (HDH) with workplaces with a larger proportion of dentists than dental hygienists (HD) on the physical and psychosocial work load, musculoskeletal and psychosomatic disorders and sickness presence.
  
  
  METHODS
  A total of 298 persons employed in the Public Dental Service in a Swedish County Council participated in this study.
  
  
  CONCLUSIONS
  The medium large clinics HDH reported 85% of employee's with considerably more high psychosocial demands compared to employees in medium HD (53%) and large HD (57%). Employees in medium large clinics HDH also reported sleep problems due to work (25%) compared with employees in medium large clinics HD (6%), large clinics HD (11%) and small clinics HDH (3%). Clinic size does not seem to influence the outcome of the HD and HD clinics to any great extent. Of all employees, about 94-100% reported high precision demands and 78-91% poor work postures.
authors.affiliation: a Futurum, Academy for Health and Care , Jönköping County Council , Sweden ;|b Department of Behavioral Science and Social Work, School of Health and Welfare , Jönköping University , Jönköping , Sweden ;
authors.forename: Bo
authors.initials: B
authors.lastname: Rolander
authors.affiliation: c Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine Center , Linköping University , Linköping , Sweden ;|d Intervention and Implementation Research Unit , Karolinska Institutet , Stockholm , Sweden ;
authors.forename: Charlotte
authors.initials: C
authors.lastname: Wåhlin
authors.affiliation: e School of Health and Rehabilitation Sciences , University of Queensland , Brisbane , Australia ;
authors.forename: Venerina
authors.initials: V
authors.lastname: Johnston
authors.affiliation: f Department of Rehabilitation, School of Health and Welfare , Jönköping University , Jönköping , Sweden ;
authors.forename: Petra
authors.initials: P
authors.lastname: Wagman
authors.affiliation: g Department of Natural Sciences and Biomedicine, Centre for Oral Health at School of Health and Welfare , Jönköping University , Jönköping , Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Lindmark
mesh_terms: D003729:Dental Care / Q000458:organization & administration* / Q000639:trends; D003752:Dental Health Services / Q000458:organization & administration* / Q000639:trends; D003756:Dental Hygienists / Q000592:standards; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005792:General Practice, Dental / Q000458:organization & administration / Q000592:standards; D006801:Humans; D008297:Male; D011636:Public Health Dentistry / Q000458:organization & administration* / Q000639:trends; D017150:Public Sector; D013548:Sweden; D016526:Workload
keywords: Dentistry employees; psychosocial workload; sickness absence; sickness presence; work organization