Manpower planning in periodontology--how many specialists do we need?

Given that one of the major focus points within this issue of the journal is 'practical periodontal medicine' and the relationship between periodontal disease and systemic chronic diseases, it is surprising that we have no indication of the manpower required to secure better oral and general health in this field. Despite many of the heralded improvements in dental health reported in the Adult Dental Health Survey 2009, as monitored by the falling rates of edentulous subjects and decayed, missing and filled teeth (DMF), the overall increase between 1998 and 2009 in the number of subjects with deep pockets from 6% to 8% has largely gone unnoticed! This is a major concern given that most other indicators of oral health have improved over this time period. Furthermore, the tissue damage associated with periodontitis is largely irreversible, and has consequences not only for oral function and quality of life, but also may adversely impact on aspects of general health. This article aims to highlight why we need specialists in periodontics, which patients should be referred to them, how big a problem periodontal disease is and how many specialists in periodontics would be required to meet this treatment need. Estimates are made using the information gained from the Adult Dental Health Survey 2009 and the Office for National Statistics 2011 census, along with estimates of the average patient pool managed within specialist periodontal practices. However, the paper emphasises that these are estimates based on incomplete information which would be necessary to allow more complete models of manpower planning to be used.