What question did this study set out to answer?

This study aims to quantify dental workforce capacity and assess implications for public oral health equity in Spain.

June 19, 20260 citations

Public Dental Workforce Capacity and Inequality in Spain.

MEManuel Jesús Enciso-RipollUniversidad Cardenal Herrera CEU JIJosé Enrique Iranzo‐CortésUniversitat de València MBManuel BravoUniversidad de Granada

Key Points

This study aims to quantify dental workforce capacity and assess implications for public oral health equity in Spain.
Conducted a cross-sectional national workforce analysis across 17 Autonomous Communities and Ceuta and Melilla.
Utilized transparency requests, official registration data, population statistics, and Ministry of Health records.
Calculated indicators like total and salaried public dentists per 100,000 inhabitants and Structural Dependence Index.
Spain had 42,860 active dentists (84.68/100,000) but only 1,685 salaried public dentists (3.36/100,000).
Public/total dentist ratio varied, with Madrid at 2.0% and Castilla-La Mancha at 7.6%.
SDI indices showed high reliance on private providers, particularly in País Vasco (95.4%) and ten mixed-model regions above 80%.

Abstract

INTRODUCTION AND AIMS: Spain combines one of Europe's highest dentist densities with limited public oral health coverage and marked regional variation in publicly funded provision. This study quantified total, salaried public and privately accredited dental workforce capacity across Spain and assessed implications for public oral health system planning and equity. METHODS: A cross-sectional national workforce analysis was conducted across the 17 Autonomous Communities and the Autonomous Cities of Ceuta and Melilla. Data were obtained through formal transparency requests to all administrations, supplemented by official professional registration data, population statistics and Ministry of Health records. Indicators included total and salaried public dentists per 100,000 inhabitants, population load per public dentist, the public/total ratio and a Structural Dependence Index (SDI) quantifying reliance on accredited private providers. RESULTS: In 2024-2025, Spain registered 42,860 active dentists (84.68/100,000) but only 1685 salaried public dentists (mean territorial density: 3.36/100,000; mean territorial load: 31,590 inhabitants per public dentist). The public/total ratio ranged from 2.0% in Madrid to 7.6% in Castilla-La Mancha. A further 6810 privately accredited providers participated in publicly funded programmes across 11 mixed-model regions, yielding an effective public-system workforce of 8495 professionals (17.21/100,000). Among territories with reported individual accredited-provider counts, SDI ranged from 0% in direct public-provision regions to 95.4% in País Vasco; ten of eleven mixed-model regions recorded SDI values above 80%. CONCLUSION: Spain does not face a shortage of dentists, but a structural imbalance between abundant private professional supply and limited, unevenly distributed public-system capacity. CLINICAL RELEVANCE: High aggregate dentist density is a poor proxy for public oral health system capacity. Workforce planning standards and stronger monitoring systems are needed to translate expanded publicly funded oral health coverage into effective and equitable access.

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