Pediatric Dentistry Workforce in Puerto Rico: Results of a 2011 Survey

To determine practicing pediatric dentists' (PD) socio-demographic and practice characteristics, geographic distribution, levels of satisfaction and desire of relocation to the United States (US).

A 34-item questionnaire was developed and pre-tested for reliability (=0.92) and content validity, and administered via telephone by a calibrated interviewer. Statistical analyses were conducted using SPSSv.19. PD practice locations were mapped using a geographic information system in ArcGISv.10. Disparities in distribution were measured by plotting the Lorenz curve and calculating the Gini coefficient (GC).

Of 75 licensed PD in Puerto Rico (PR), 60 (80%) participated in our study. The typical PD has been in practice 19 yrs, is 48 years old, and spends 31 hrs/week providing clinical care. Female PD are 70% of the workforce. Thirty-nine (65%) participate in the government-subsidized dental insurance program “La Reforma”, which represents 48% of their income. PD locate their offices in urban and higher-income areas (GC=0.62). Although 36 (60%) are satisfied practicing in PR, 34 (57%) have considered migrating to the US. Variables significantly associated (P.05) with dissatisfaction included age ( 50 years old), years in practice ( 20 years), and participation in “La Reforma”.

The supply and characteristics of PD must be monitored to ensure an adequate workforce. These variables should be examined in relation to epidemiological indicators, availability of community preventive programs, and adequacy of dental benefits and reimbursement levels provided by third-party payers. Dramatic changes in the financing of dental care may be necessary to prevent a shortage of PD and ensuing oral health crises.