The status of hospital dentistry in Taiwan in October 2019

The relationship between graduation school background and geographical distribution of dentists in Taiwan

Background/purpose

Taiwan's eight dental schools are all located in the western region. This study attempted to analyze the relationship between the geographical distribution of dentists in Taiwan and their graduation school background and to develop several statistical indicators to analyze the geographical distribution of dentists.

Materials and methods

The method of the secondary data analysis was adopted to collect the open information related to the number of the practicing dentists based on their graduation schools and practice locations by cities and counties in Taiwan in January 2023. The data were used to develop several statistical indicators to analyze the geographical distribution of dentists.

Results

There were 16,533 practicing dentists in Taiwan in January 2023. Of the 16,533 dentists, 15,687 (94.88 %) graduated from domestic dental schools and 846 (5.12 %) graduated from foreign dental schools. For the school location, the coefficient of variation, Gini coefficient, population proportion index, and population density index were the largest (168.57 %, 0.47, 10.76 %, and 3927.01 people/square kilometer) in the dentists graduating from the northern dental schools. In overall, the dentists were concentrated in municipalities, cities, and the northern region of Taiwan, especially those graduating from the northern dental schools.

Conclusion

In Taiwan, the geographical distribution of dentists is highly related to their graduation school background. Promoting a balanced distribution of dental enrollment quotas and dental student sources from different geographical locations and inducing the movement of dentists to the dentist-shortage areas may be the more feasible ways to solve the uneven geographical distribution of dentists in Taiwan.

Online courses for dentist continuing education: A new trend after the COVID-19 pandemic

Background/purpose

Online courses have been widely used in all levels of education during the COVID-19 pandemic. This study explored the effectiveness of a dentist continuing education (DCE) course through the online devices in Taiwan.

Materials and methods

The practicing dentists who participated in the online course of dental radiation technology for DCE offered by the Taiwan Dental Association (TWDA) in October 2022 and in March 2023 were enrolled in this study. The composition of participating dentists was confirmed by the public inquiry system and their learning effectiveness was evaluated by a questionnaire-based survey after the online DCE class.

Results

All participating dentists (132 in October 2022 and 117 in March 2023) obtained consistent good learning outcomes in this online DCE course. Of these 249 dentists, there were 170 (68.27%) males and 79 (31.73%) females, 127 (51.00%) dental specialists and 122 (49.00%) general dentists, as well as 50 (20.08%) hospital dentists and 199 (79.92%) clinic dentists. The participation rates for this course of practicing dentists in non-municipalities (4.70%), counties (3.88%), eastern region (8.08%), and outlying islands (3.60%) were much higher than those in municipalities (0.79%), cities (1.16%), and the western region including the northern region (0.88%), central region (1.96%), and southern region (1.94%), respectively.

Conclusion

The participating dentists express positive feedback on the online DCE courses, and the online DCE courses can reduce the urban-rural gap in dental education resources. The use of online DCE courses in dental education will be a future trend.

Morbidity and mortality of oral cancer in Taiwan: Trends from 2000 to 2021

Background/purpose

Oral cancer is a major cause of cancer morbidity and mortality worldwide, especially in Taiwan. This study investigated the morbidity and mortality of oral cancer in Taiwan from 2000 to 2021.

Materials and methods

The population data and the records of cancer registry were obtained from the websites of the Ministry of the Interior and the Ministry of Health and Welfare, respectively. The numbers of oral cancer cases and deaths were analyzed from 2000 to 2021.

Results

The numbers of oral cancer cases and deaths increased from 3378 to 1494 in 2000-8277 in 2020 and 3395 in 2021, respectively. The total increase of oral cancer cases was 4899 with a total increase rate of 145.03%, while the total increase of oral cancer deaths was 1901 with a total increase rate of 127.24%. The changes in the numbers of all cancer cases and deaths, as well as the morbidity and mortality of oral cancer or all cancers also showed similar trends. Furthermore, the death-to-case ratio of oral cancers decreased from 44.23% in 2000 to 40.84% in 2020. The total decrease was 3.39% with a total decrease rate of 7.66%.

Conclusion

In Taiwan, people's awareness of oral mucosal health is still inadequate. Obviously, there is still much room for improvement in the oral mucosal health education for our people. With the expertise and responsibility for taking good care of oral health of our people, the dental personnel should take active roles in the prevention and screening for oral cancers.

Correlation between dental professionally topical fluoride application and children's dental use for dental caries under the National Health Insurance system in Taiwan from 2008 to 2021

Background/purpose

Dental caries is one of the most common oral diseases in children worldwide, especially in Taiwan. This study investigated dental professionally topical fluoride application (PTFA) and children's dental use for dental caries under the National Health Insurance (NHI) system in Taiwan from 2008 to 2021.

Materials and methods

The population data and medical records of the NHI system were obtained from the websites of the Ministry of the Interior and the Ministry of Health and Welfare, respectively. The dental PTFA services and dental use indicators for dental caries were analyzed from 2008 to 2021.

Results

The number of out-patient visits for dental PTFA services increased from 221,675 in 2008 to 1,078,099 in 2021. The total increase of the out-patient visits was 856,424 with a total increase rate of 386.34%. The one-year increase was 65,879 with a one-year increase rate of 29.72%. Among the 3 age groups of children, their dental use indicators almost presented decreasing trends from 2008 to 2021. Moreover, in general, the dental use indicators showed a negative correlation with the number of the overall out-patient visits for dental PTFA services from 2008 to 2021.

Conclusion

In Taiwan, there is a negative correlation between the dental use indicators in NHI system and the number of the overall out-patient visits for dental PTFA services from 2008 to 2021. However, the problem of dental caries in children is still serious and there is still a space for improvement in the oral health education for child caregivers and children.

Overview of dental professionally topical fluoride application in public health measure in Taiwan in 2021

Background/purpose

In Taiwan, it has been 16 years since the policy of children's dental professionally topical fluoride application (PTFA) services was implemented. This study investigated the differences in the number of children's dental PTFA outpatient visits among cities and counties or different regions of Taiwan in 2021.

Materials and methods

The population data and medical records of the number of children's dental PTFA outpatient visits were obtained from the websites of Ministry of the Interior and Ministry of Health and Welfare, respectively. The secondary data were divided by cities and counties to analyze the urban-rural gap and regional differences in the number of children's dental PTFA outpatient visits in Taiwan in 2021.

Results

In Taiwan, municipalities had the largest number of dental PTFA visits (721,338, 66.91% of the total dental PTFA visits), while remote and outlying island counties had the smallest number of dental PTFA visits (84,509, 7.84%). The northern region had the largest number of dental PTFA visits (466,728, 43.29%), while outlying islands had the smallest number of dental PTFA visits (25,055, 2.32%). Based on the children aged 3-5 years, municipalities had the lowest dental PTFA use rate (171.70%), while remote and outlying island counties had the highest dental PTFA use rate (482.96%).

Conclusion

In Taiwan, there is a higher number of children's dental PTFA outpatient visits in municipalities than in non-municipalities or remote and outlying island counties as well as in northern region than in each of other four regions (central, southern, and eastern regions and outlying islands).

Overview of dental radiology education for medical radiology students in Taiwan

Background/purpose

In Taiwan, the formal education for cultivating medical radiation technologists began in 1965. However, there are very few dental radiology curricula in Taiwan's medical radiology schools. We investigated mainly the appearance of dental radiology education for medical radiology students in Taiwan.

Materials and methods

We used documentary analysis, a survey of dental radiology education, and secondary data analysis in this study to find the appearance of Taiwan's dental radiology education for medical radiology students.

Results

There were currently ten medical radiology schools. Among them, five offered independent curricula in their subject schedules and another five had dental radiology education included in their general medical radiology curricula. Of the 53 dental radiology teaching hospitals, 21 (39.62%) were medical centers and 25 (47.17%) were regional hospitals, and these large hospitals were concentrated in the northern region of Taiwan. These large dental radiology teaching hospitals offered more training hours of dental radiology internship for medical radiology students and had a higher availability for the medical radiology students.

Conclusion

In Taiwan, the current status of dental radiology curricula in the medical radiology schools is indeed seriously insufficient. A dental radiology education system should be established in the future, including the innovative dental radiology curricula developed for medical radiology students and more dental radiology curricula designed for dental students. This in turn can create new career options for medical radiology students and new practice directions for medical radiation technologists, and then expand their potential involvement in dental radiology.

Overview of dental education system and gender distribution of undergraduate dental students in Taiwan

Abstract Background/purpose

The gender distribution of dentists in Taiwan has been dominated by male dentists for a long time. This study analyzed preliminarily the appearance of the current dental education system and the gender distribution of undergraduate dental students.

Materials and methods

This study used documentary analysis and secondary data analysis to survey mainly the current dental education system and the gender distribution of undergraduate dental students in Taiwan.

Results

There were a total of 2474 dental students and 394 dental graduates in Taiwan in 2021. The numbers of male students (1435, 58.00%) and male graduates (207, 52.54%) were higher than those of female students (1039, 42.00%) and female graduates (187, 47.46%). The numbers of male dental students in the northern (629), central (428), and southern (378) regions were all higher than those of female dental students (423, 373, and 243, respectively). The chi-square test indicated the significantly higher proportion of male dental students in the northern and southern regions (P < 0.01). Besides, there were a total of 15,857 registered dentists. The number of male dentists (10,997, 69.35%) was higher than that of female dentists (4,860, 30.65%). Compared with population, the chi-square test showed the significantly higher proportion of male dental students and male registered dentists (all P-values < 0.001).

Conclusion

In Taiwan, the dental education system must promote female students' interest in dentistry and elevate the proportion of female dental supervisors to increase the proportion of female dental students and female dentists in the future.

An exploration of the connotation of clinical dental radiology education for medical radiation students in Taiwan in 2022

Background/purpose

In Taiwan, the dental radiology has a history of more than 100 years. However, medical radiation schools or teaching hospitals have not yet established a set of standard learning content for dental radiology internship.

Materials and methods

We used the observational method and dental radiology teaching survey to explore the connotation of clinical dental radiology education for medical radiation students in Taiwan.

Results

There were 64 dental departments of hospitals with their own independent dental radiology departments in Taiwan in 2022. Among them, 58 (90.63%) were in the teaching hospitals. Of the 58 dental radiology departments in the teaching hospitals, 40 (68.97%) had medical radiation interns in their dental radiology departments. There was a complete set of seven training items for dental radiology internship. The mean training items in the medical centers (4.94) was significantly higher than that in the regional hospital (3.9) (P < 0.05). No matter what level of hospital, it is the most common way to implement the training mode with preclinical exercises and then clinical practice.

Conclusion

In Taiwan, the current status of dental radiology teachers in the teaching hospital is indeed seriously insufficient. It is necessary to establish a standard dental radiology education system, including setting one common dental radiology subject for medical radiation students, and the relevant regulations to formulate the basic requirements of the training items and training hours for dental radiology internship. Thus, medical radiation interns can acquire the operation skills related to dental X-ray machines after completing the internship training.

Overview of dental radiation technologists in Taiwan

Background/purpose

In Taiwan, there is no independent licensing system for dental radiation technologists. A licensed medical radiation technologist who engages in dental radiology is the so-called dental radiation technologist. This study explored mainly the profile of dental radiation technologists in Taiwan.

Materials and methods

This study used the methods of documentary analysis, dental radiation manpower survey, and the secondary data analysis to find the profile of dental radiation technologists in Taiwan.

Results

There were currently 59 dental radiology departments and 101 dental radiation technologists (29 males and 72 females) in 57 hospitals and their branches. Of the 101 dental radiation technologists, 56 worked in the medical centers, 28 in the regional hospitals, and 17 in the district hospitals. More than half of the dental radiation technologists were concentrated in the medical centers (55.45%, 56/101) or the northern region of Taiwan (57.43%, 58/101), especially in the northern medical centers (30.69%, 31/101).

Conclusion

In Taiwan, the manpower of dental radiation technologists is insufficient, and dental radiation technologists usually work in the dental departments of the hospitals. A large number of clinic dentists lack dental radiation technologists to assist in dental radiology works and the clinic dentists have to perform the dental radiology works by themselves. Therefore, a dental radiology education system should be established to design innovative dental radiology courses for radiological technology students. This in turn can provide a new practice direction for medical radiation technologists and expand their potential participation in the field of dental radiology.

Overview of dental assistants in Taiwan from 2009 to 2021

Background/purpose

Materials and methods

Results

Conclusion

The current dental school admissions: An overview of the admission process and the geographical distribution of dental school enrollees in Taiwan

Background/purpose

There is no specific admission system for dentistry in Taiwan. The aims of this study were to describe and analyze the current admission processes for entry into dental schools through the university admission system and to compare the geographical distribution of dental school enrollees.

Materials and methods

All seven dental schools of general universities in Taiwan were included to analyze the admission protocols in 2019 and 2020. All data of dental enrollment quotas and dental school enrollees presented in this study were collected from information available to the public on the related websites.

Results

The total dental enrollment quotas via the university admission system were 381 in 2019 and 397 in 2020. Those admitted via the special program for indigenous peoples and offshore island peoples were both 27 in 2019 and 2020, respectively. The main dental school admission way was individual application, and the main providers of dental enrollment quotas were northern dental schools and private dental schools. In addition, dental school enrollees were concentrated in the northern region, municipalities, and cities in Taiwan.

Conclusion

Further advancement is needed to expand participation and broaden the sociodemographic profile of dental school applicants. The dental schools would benefit from a long-term prospective study about the correlation of admission methods with students' performance in dental schools. The special program is impacting the equality of admission opportunities. It is necessary to track the practice dynamics of these dental school graduates who were enrolled via the special program as a basis for policy adjustment.

Dental manpower and treated dental diseases in department of dentistry, Taipei Hospital (the predecessor of National Taiwan University Hospital) in 1923

Background/purpose

In 1906, there was a dental treatment room established in the department of surgery of Taipei Hospital to introduce modern dental services to Taiwan. It is undoubtedly the earliest hospital dentistry in Taiwan. This study tried to assess the dental manpower and treated dental diseases in Taipei Hospital, and hence to explore the appearance of Taiwan's early hospital dentistry.

Materials and methods

This study utilized the secondary data analysis to evaluate the dental manpower and treated dental diseases of dental outpatients in the 27th Annual Report of Taipei Hospital (Taisho 12th year or 1923).

Results

Our results found that there were 3 dentists and one dental technician in the dental department of Taipei Hospital in 1923. These 3 dentists totally treated 3 inpatients and 1759 outpatients with 4511 outpatient visits (1959 for male patients and 2552 for female patients) in that year. Dental caries and retained root were the two most common dental diseases in Japanese and Taiwanese dental outpatients, and followed in a descending order by missing tooth, pulp necrosis, and pulpitis for Japanese outpatients as well as pulpitis, suppurative periodontitis, and acute or chronic periodontitis for Taiwanese outpatients.

Conclusion

We conclude that the dentistry of Taipei Hospital in 1923 does have a modern form of dentistry with 3 dentists and one dental technician. Its dental patients are mainly Japanese and minorly Taiwanese. Moreover, the treated dental diseases are mainly tooth diseases for Japanese outpatients and both tooth and periodontal diseases for Taiwanese outpatients.

The training effectiveness of dental trainees in postgraduate year training program for dentists

Background/purpose

Taiwan's two-year postgraduate year training program for dentists (PGYD) has been implemented since 2010. However, there was no relevant study for confirming the training effectiveness of PGYD trainees. This study evaluated whether different training institution attributes and different training modes for PGYD trainees could result in differences in the achievement of PGYD training purposes.

Materials and methods

We adopted the questionnaire survey to collect the views of PGYD trainees on the training effectiveness of PGYD and further evaluated whether different training institution attributes and different training modes for PGYD trainees could result in differences in the achievement of PGYD training purposes.

Results

For the "patient-centered" learning environment and the management ability to be a responsible dental clinic owner, the views of PGYD trainees in dental clinics and district hospitals were more positive than those in medical centers. For the clinical professional ability and the management ability to be a responsible dental clinic owner, the views of PGYD trainees in joint group were more positive than those in single hospital.

Conclusion

We conclude that both hospitals and dental clinics can achieve PGYD training purposes. The smaller training institutions (dental clinics or district hospitals) are better training institution attributes and the joint group is the better training mode to achieve PGYD training purposes. The joint groups with medical centers combining many dental clinics, especially those in remote areas, may be an excellent training mode, because this training mode has the high potential to subsequently balance the distribution of dentists in Taiwan.

Distributions of dental freshmen enrolled by northern, central, and southern dental schools in each city or county and different regions of Taiwan in 2020

Background/purpose

In Taiwan, the uneven distribution and the urban-rural gap of dentists are long-standing problems. Thus, the regional balance of domestic dental schools and their students are very important for the further distribution of practicing dentists. The main purpose of this study was to evaluate the distributions of dental freshmen enrolled by dental schools of general universities in each city or county and different regions of Taiwan in 2020.

Materials and methods

This study mainly collected the number of dental freshmen enrolled by the northern, central, and southern dental schools and further evaluated their distributions in each city or county and different regions of Taiwan in 2020.

Results

The distribution of dental freshmen in Taiwan in 2020 did have a regional imbalance. These dental freshmen were mainly concentrated in municipalities, cities with dental schools, and the northern region of Taiwan. The enrolled dental freshmen tended to choose a dental school which was in the same location as they grew up. We also found that the dental freshmen enrolled by the northern, central, and southern dental schools mostly came from the northern, the northern, and the southern regions of Taiwan, respectively.

Conclusion

We conclude that the dental freshmen are mainly concentrated in municipalities, cities with dental schools, and the northern region of Taiwan. Moreover, the dental freshmen enrolled by the northern or central dental schools mostly come from the northern region of Taiwan and those enrolled by the southern dental schools majorly come from the southern region of Taiwan.

Distributions of dental freshmen and practicing dentists and their correlations in different regions of Taiwan in 2020

Background/purpose

Taiwan is facing the problems of the surplus, the uneven distribution, and the urban-rural gap of dental students and practicing dentists. The main purpose of this study was to evaluate the distributions of dental freshmen and practicing dentists in different regions of Taiwan in 2020.

Materials and methods

We collected the numbers of dental freshmen and practicing dentists in different regions of Taiwan in 2020 for evaluation of their regional distributions in Taiwan and their relationship by the regression analysis.

Results

The numbers of dental freshmen and of practicing dentists per 100,000 people in municipalities were higher than those in non-municipalities (P < 0.01 for practicing dentists only). These corresponding numbers in cities with dental schools were significantly higher than those in cities and counties without dental schools, respectively (all P-values < 0.05). In addition, the coefficients of correlation between the dentist index and the dental student index were R² = 0.7521 (P < 0.05) for municipalities (n = 6), R² = 0.6332 (P < 0.001) for non-municipalities (n = 15), R² = 0.9334 (P < 0.05) for cities with dental schools (n = 4), R² = 0.4925 (P < 0.01) for cities and counties without dental schools (n = 17), and R² = 0.5025 (P < 0.001) for nationwide (n = 21).

Conclusion

The dental freshmen and practicing dentists are still more concentrated in municipalities than in non-municipalities and in cities with dental schools than in cities and counties without dental schools in Taiwan in 2020.

Current practice patterns and training project of orthodontic specialists in Taiwan in 2020

Background/purpose

There were 661 board-certified orthodontic specialists in Taiwan in 2020. This study reported the current practice patterns and training project of orthodontic specialist in Taiwan.

Materials and methods

This study exploited the secondary data analysis and interview to survey the current practice patterns and training project of orthodontic specialists in Taiwan.

Results

Of the 661 orthodontic specialists, there were 84 registered in the medical centers, 44 in the regional hospitals, 7 in the district hospitals, and 526 in the dental clinics, respectively. There were 20 orthodontic specialist training institutions (15 medical centers, 3 regional hospitals, one district hospital, and one dental clinic) that had 218 dentists in orthodontic departments of training institutions and a training capacity of 51 dentists. Of the 20 orthodontic specialist training institutions in Taiwan in 2020, 12 were located in the northern, 4 in the central, and 4 in the southern regions of Taiwan. Moreover, we found none of the training institutions in the eastern and offshore island regions of Taiwan and the number of the orthodontic specialists did increase along with the population and the number of the practicing dentists.

Conclusion

There are three major orthodontic specialist occupation problems in Taiwan: a surplus of the orthodontic specialists in the near future, an uneven distribution of the orthodontic specialists, and a concentration of the orthodontic specialists in the metropolitan areas of the municipalities. Therefore, we suggest that the government and relevant professional groups should propose solutions for these problems as soon as possible.

Regional distributions of overall dentists and institutional dentists in Taiwan in 2019

Background/purpose

Taiwan is facing a huge urban-rural gap in the human resources of dentists between cities and counties. Although the postgraduate year training program for dentists (PGYD) was implemented in Taiwan in 2010, the uneven distribution of dentists is still a serious problem. The purpose of this study was to evaluate the distributions of overall dentists and dental training institutions and their dentists (so-called institutional dentists) in each city and county in 2019 to further analyze the regional distributions of overall dentists and institutional dentists in Taiwan.

Materials and methods

This study collected the numbers of dentists, dental training institutions, and institutional dentists in each city and county in 2019 for evaluating the regional distributions of dentists and institutional dentists in Taiwan.

Results

The numbers of dentists and institutional dentists in municipalities were significantly higher than those in non-municipalities in Taiwan, respectively. The coefficient of variation was greatest for dentists in the single-system institutions (1.72) and program-management institutions (1.87). The coefficients of correlation between the dentist index and institutional dentist index were R² = 0.9805 (P < 0.001) for municipalities, R² = 0.4523 (P < 0.01) for non-municipalities, and R² = 0.7691 (P < 0.001) for nationwide.

Conclusion

The dentist manpower and dental training institutions are concentrated in municipalities of Taiwan. The quantitative and qualitative improvement of collaborating institutions in the PGYD system may have an influence on the distribution of new-entry dentists and contribute to establishment of an effective regional dental health care service.