Working age population projections - implications for dentistry

This will have implications for the dental workforce, which like the Australian population is ageing.
 
According to projections supplied to the Department of Education, Employment and Workplace Relations (DEEWR) by Access Economics in 2004, whilst the working age population grew by around 180,000 people every year, the working age population will now grow by just 175,000 for the entire decade of the 2020s.  
 
Australian Bureau of Statistics (ABS) data supports such trends. According to the
latest population projections released by the ABS in November 20052, Australia will look very different in 2051, with almost half the population being older than 50 years.
 
By 2051 Australia's population is expected to increase to between 25 and 33 million people, with around 44% to 48% being older than 50 years. In 2004 Australia's population was 20 million people, with almost one third being older than 50 years. The ageing of Australia's population is the result of sustained low fertility, combined with increasing life expectancy at birth.
 
The number of people aged 65 years and over will increase rapidly over the next 50 years, from 2.6 million in 2004 to between 7 and 9 million people in 2051; whilst the number of people aged 85 years and over will increase even faster, from just under 300,000 people in 2004 to between 1.6 million and 2.7 million people in 2051.  
 
Australia's population aged 15-64 years, which encompasses much of the working-age population, is projected to decline from 67% in 2004 to between 57% and 59% in 2051.
 
This decline in growth, and ultimately the decline in the actual size of the workforce- age population have implications for the dental workforce.
 
The dental workforce is ageing. Earlier research suggests that as the large baby
boomer cohort retires dental shortages may likely increase. Since 1986, the dental
workforce has aged significantly. About half of the current dental workforce
is projected to retire by 2026. Generation X dentists are significantly less likely to
work long hours than the baby boomer cohort of dentists. This is partly due to an
increase in the proportion of women in the dental workforce and male Generation X dentists being less likely to work long hours than male baby boomer dentists.
 
The capacity to provide dental services falling well short of demand has been espoused for some time.  Proponents of this line of thinking argue the need to improve dentist numbers in Australia.  This may have been valid when in 2002 projections of supply and demand for 2010 showed a considerable shortfall in supply.  However, in the four years since that information was made available many parameters around the dental labour force have changed. The perception currently being held that a dental workforce shortage exists is totally misplaced.   
 
The creation of new dental schools in Griffith, La Trobe, Charles Sturt and James Cook Universities, existing schools gearing up to produce more graduates and with an increased number of overseas trained dentists successfully completing ADC’s examinations, it is now evident that a sizeable increase has occurred in the
recruitment of dentists in Australia.  
 
The dental workforce, though ageing, is not facing a shortfall problem per se. In fact there is every indication that there may be an oversupply by 2025.  The problem rests with a maldistribution in the current supply of dentists - this is the issue that needs to be addressed.  A shortage of dentists in rural and remote areas is negatively impacting on the delivery of services in those areas of need and makes timely and affordable access to dental treatment a difficult proposition for many Australians.
 
For example, in 2003, there was an estimated 9678 practicing dentists which
represented a ratio of 48.7 dentists per 100,000 population. Workforce shortages were most acute in outer regional (27.7 dentists per 100,000 population) and remote/very remote parts of Australia (18.1 dentists per 100,000 population).
 
The ADA recognises that the demand for dental visits and the supply of the dental
workforce is an inexact science, but the current research tells us that we should
probably have a pause in either growth of existing dental schools or new dental
schools. Some of that time could be used exploring further research questions and
developing new models. Simply investing in new dental schools or creating more
graduates is not the answer and will not solve distributional issues in rural areas.  
These issues need to be tackled through policy that specifically addresses rural
distribution, public sector employment and a shift in the balance of dentists and
therapists/hygienists.
 
In its 2008-09 pre-budget submission the ADA recommended additional expenditure for dental workforce including increased subsidies to encourage dentists to particularly work in areas of need including regional, rural and remote Australia and the public service; and providing financial assistance directly to Schools of Dentistry to assist with recruitment and retention of academic staff to alleviate shortages in the current academic dental workforce.