Public Dental Workforce Capacity and Inequality in Spain

Area of Science:

• Health Services Research
• Public Health Policy
• Dental Workforce Analysis

Background:

• Spain has a high number of dentists per capita, yet public oral health coverage is limited and varies regionally.
• Understanding the distribution and capacity of the dental workforce is crucial for effective public health planning.

Purpose of the Study:

• To quantify the total, salaried public, and privately accredited dental workforce in Spain.
• To assess the implications of workforce distribution for public oral health system planning and equity.

Main Methods:

• A cross-sectional national workforce analysis was conducted across Spain's Autonomous Communities.
• Data were gathered via transparency requests, professional registration, population statistics, and Ministry of Health records.
• Key indicators included dentists per 100,000 inhabitants, public/total dentist ratios, and a Structural Dependence Index (SDI).

Main Results:

• Spain has 42,860 active dentists (84.68/100,000) but only 1685 salaried public dentists (3.36/100,000).
• The public/total dentist ratio varied significantly by region, from 2.0% to 7.6%.
• Privately accredited providers in public programs and high SDI values (up to 95.4%) indicate significant reliance on private capacity in mixed-model regions.

Conclusions:

• Spain faces a structural imbalance: abundant private dental supply versus limited and unevenly distributed public capacity.
• High overall dentist density does not equate to strong public oral health system capacity.
• Improved workforce planning and monitoring are essential for equitable access to expanded public oral health coverage.