Workforce skill mix: modelling the potential for dental therapists in state-funded primary dental care

South Central Strategic Health Authority [SHA], with a population of four million, is one of 10 regions of England with responsibility for workforce planning.

To explore future scenarios for the use of the skill mix within the dental team to inform the commissioning of dental therapy training.

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.

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.

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.