Needs-Based Planning of Human Resources for Children’s Oral Health in China Based on Data of National Oral Health Surveys

Introduction and aims Currently, oral health workforce requirements for children and adolescents in China remain insufficiently quantified and unevenly distributed. Needs-based workforce planning models using national survey data provide an approach to address this gap. Methods Based on data from the two most recent rounds of National Oral Health Surveys of China (3rd survey in 2005 and 4th survey in 2015), reporting baseline caries prevalence of 71.9% for 5-year-olds and 38.5% for 12-year-olds in 2015, needs-based workforce requirements were estimated for children and adolescents aged 1 to 17 years at national and provincial levels. Survey-specific caries risk stratification models were incorporated into minimum and maximum intervention scenarios. Estimated workforce requirements were then compared with current dental workforce supply data. Results Assuming a 70% clinical-time allocation, approximately 573,000 to 902,000 dental practitioners were estimated to be required to fully meet national needs for caries prevention and treatment. However, the current oral health workforce could only provide minimum intervention coverage for approximately 54.3% of the population. Profound structural imbalances were evident, with substantial disparities between urban and rural areas. Rural areas had lower oral health workforce supply coverage in both survey years than urban. In addition, substantial disparities existed among economic regions. Higher-income province-level administrative units approached workforce sufficiency for estimated requirements, particularly in urban areas, whereas western province-level administrative units faced substantial shortages, meeting less than 30% of estimated requirements, with more than 80% attributable to rural areas. Conclusion There was a critical gap between oral health needs of the Chinese population and the supply of human resources for oral health, characterized by substantial urban-rural and inter-regional inequalities. Clinical relevance Our findings highlight the urgent need for policy interventions to expand the overall workforce, optimize its geographic distribution and skill mix, and ensure adequate oral health coverage and equity in China.