Actions for reforming oral healthcare to combat Noncommunicable disease: A workforce challenge.

INTRODUCTION

Oral health policies to mitigate the global burden of noncommunicable disease typically advocate for effective workforce policies. However, actions on oral healthcare are often unclear and disengaged from other health policies.

OBJECTIVES

This review investigates evidence of the oral health workforce, identifies challenges, possible solutions, and calls for a reformation to mitigate the burden of oral diseases.

DATA SOURCES AND SELECTION: International reports and related literature were searched and reviewed using a realistic approach focused on the global oral and general health workforces.

CONCLUSIONS

Dental professions almost everywhere are only peripherally involved in primary care, and dental workforces are sustained with much disparity typically by addressing dentist-to-population ratios without much attention to the realistic needs of communities. Effectiveness is hindered by insufficient interdisciplinary team-care, restricted scope of service, vaguely conceived essential oral care, expensive clinical education, and general misdirection of services.

CLINICAL SIGNIFICANCE: Calls for reform include: (1) identifying key local advocates for reform, including academics, community-based organisations, healthcare providers, and politicians; (2) analysing disparities of essential needs and resources for oral care, and implementing necessary changes to local healthcare systems; (3) financing accessible oral care; (4) fostering equity and universal health coverage through cultural sensitivity and interdisciplinary teamwork; (5) clarifying scopes of practice, accreditation standards, and legal foundations for team-care; (6) identifying educational gaps in workforces; (7) promoting reduction of student debt; (8) supporting culturally diverse education for disadvantaged communities; (9) improving quality and accessibility of care; and (10) realistically planning the oral workforce based on local estimates of essential need.