Orthodontic work-force survey indicates shortage of orthodontic specialists in the United Kingdom

A recent orthodontic work-force survey has confirmed that there is a shortage of orthodontic specialists in the United Kingdom (UK). In comparison to the rest of Europe, the UK has the third highest patient-to-specialist ratio. Only Spain and Turkey have higher ratios. To date, this survey, which was commissioned by the Chief Dental Office in 2003 through the British Orthodontic Society (BOS), is the most comprehensive attempt to examine the current orthodontic work force and will provide a foundation for meeting future staffing and training needs.

The survey incorporated information from both general dentists and orthodontic specialists. The study, which was supported by a grant from the UK’s Chief Dental Officer, was conducted by the Department of Oral Health and Development at the University of Sheffield School of Clinical Dentistry in 2005.

Of the 1,660 providers of orthodontic treatment in the UK, 919 providers are orthodontic specialists. The survey determined that specialists are especially needed in the following areas of the UK: Shropshire and Staffordshire; Essex, Kent and Medway; County Durham and Tees Valley; Trent and North and East Yorkshire; and North Lincolnshire.

Among the survey’s other key findings:

• Specialists are the most efficient providers of orthodontic treatment; on average, they complete 400 cases per year. Non-specialists complete an average of 187 cases per year.  
• An additional 80 hospital-based orthodontic consultants are needed in England and Wales. These consultants treat cases that combine greatest need with greatest complexity.
• One fifth of the orthodontic specialists are due to retire in the next six years. Sixty-six of these individuals are hospital-based consultants.
• Almost 300 of the general dentists providing orthodontic treatment reported that they do not have the necessary qualifications to provide orthodontic treatment.
• On average, patients wait 24 weeks after their first orthodontic consultation before they can begin orthodontic treatment.

The BOS has posted the results of this survey on its Web site. In the online report, BOS Secretary Dr. David Tidy commented on the results.

“The BOS particularly welcomes the main conclusion of the report, which supports earlier concerns that were based on anecdotal evidence, regarding the geographical inequality in the specialist work force and the shortage of training places,” he says in the online report. “We would emphasize the need for measures to be taken at the earliest opportunity to address these issues.”

However, he notes that the survey does not address shortages among orthodontic faculty members.

“A serious omission from the report is a consideration of the shortage of academics in orthodontics,” he says in the online report. “This group is crucial in training and to the future of orthodontic services. The numbers of academics have been seriously eroded in recent years, the demands on their time have multiplied, and recruitment is increasingly difficult.”

The BOS has submitted this report to various governmental agencies. In the meantime, the National Health Service of England has made extensive policy changes that have negatively affected the provision of orthodontic health care to the citizens of England. To learn more about the NHS changes and their effects on the specialty, please refer to the article on page 4.

To learn more about the work-force survey, review the online report on the BOS Web site. Go to www.bos.org.uk. The survey is posted in the press release archive.