The twenty-first century orthodontic workforce

Orthodontic workforce planning Historically, orthodontic workforce planning has proved difficult. In 1985 Stephens et al.1 predicted an oversupply of orthodontists and yet only 13 years later the Task Group for Orthodontics identified a shortfall and recommended a target of 480 general dental service specialist practitioners for the UK. This wide ranging and perspicacious report took into account training mechanisms, European directives and wider drivers from the Chief Medical and Dental Officers. At that time they were mindful of two other unknowns in planning the workforce, the influence of ‘grandfathering’ onto specialist lists and the potential impact of ‘orthodontic auxiliaries’ as they were then known.2 The first complete survey of the orthodontic workforce in the UK was carried out during 2003 and 2004.3 This survey was commissioned by the Department of Health and carried out by the University of Sheffield. The aim was to assess the existing orthodontic workforce in relation to current and future population needs. It was questionnaire-based and investigated the location of workforce and the ratio of 12-year-olds per whole time equivalent orthodontic provider in each Strategic Health Authority. Type of provider, case mix and productivity (assessed as number of cases treated per year) were also investigated. An orthodontic provider was considered to be a specialist or non-specialist who treated more than 30 cases per year. Of the 1,660 UK orthodontic providers identified, 919 were General Dental Council (GDC) registered specialist providers. In the hospital setting, 243 NHS consultants and 68 university teachers were identified. Fiftyfive worked in a community setting and 221 were in training. The specialist practitioner group was the largest group (548) and the practitioner group (non-specialist providers) represented 26% of the workforce (432). At this time, orthodontic therapists did not exist and attempts were not made to measure their potential impact on workforce need. Several scenarios were presented with the problem of addressing the shortfall in orthodontists and it was emphasised that the demand for increased numbers of providers could be lessened if those patients falling T. Hodge1 and N. Parkin2 highlight the changes that have taken place in the orthodontic workforce over the past decade and review the roles of various members of the orthodontic team.