Dental manpower requirements in emerging countries

The training and use of dental auxiliaries in newly emerging countries are proposed as the solution in such countries to the prevalence of dental disease, the paucity of professional dentists and dental schools, and the competing demands on their economies. Statistically valid dental health surveys of many countries do not exist, but scattered evidence from Jamaica, Guatemala, Thialand, Senegal, and Kenya, among others, indicates that caries and periodontal infections are widespread, and malocclusion, malignant neoplasms of the mouth, and calcium defects are not infrequent. The ratio of dentists to population varies from 1 to 15,000 in Jamaica to 1 to 250,000 in Kenya. Only 130 to 150 dentists are gratuated each year from Africa's seven dental schools; half the countries of the world have no dental school and no prospects of attaining one. The cost of producing one professional dentist is prohibitive - $23,000 per dentist in Guatemala, for example. Auxiliaries can fulfil many basic dental needs of both children and adults in these countries. A program with three consecutive but overlapping phases is suggested. Phase one is to produce a small corps of superbly trained dentists. Phase two is to supplement this corps by giving existing paramedical and auxiliary health personnel 6 weeks of practical chairside training to develop specific cadres of trained dental auxiliaries. Single skill auxiliaries can be trained in 2 years. A dental surgeon and six auxiliaries can serve an estimated 25,000 persons. Multiple skill auxiliaries with 8 years of general education need 3 years of technical training, preferably in an institution where graduate dentists and dental hygienists are also prepared. The auxiliary's role is both as assistant to the dentist and, where supervision is remote, as his substitute. Producing two types of auxiliaries, one oriented to the dental care of children, and the second a curative care of adults, would permit the organization of dental health services on a rational priority basis. (Summary)