Estimating future dental services' demand and supply: a model for Northern Germany.

OBJECTIVES To plan dental services, a spatial estimation of future demands and supply is required. We aimed at estimating demand and supply in 2030 in Northern Germany based on the expected local socio-demography and oral-health-related morbidity, and the predicted number of dentists and their working time. METHODS All analyses were performed on zip-code level. Register data were used to determine the number of retiring dentists and to construct regression models for estimating the number of dentists moving into each zip-code area until 2030. Demand was modelled using projected demography and morbidities. Demand-supply ratios were evaluated and spatial analyses applied. Sensitivity analyses were employed to assess robustness of our findings. RESULTS Compared with 2011, the population decreased (-7% to -11%) and aged (from mean 46 to 51 years) until 2030. Oral-health-related morbidity changed, leading to more periodontal and fewer prosthetic treatments needs, with the overall demand decreasing in all scenarios (-25% to -33%). In contrast, the overall number of dentists did only limitedly change, resulting in moderate decrease in the supplied service quantities (max. -22%). Thus, the demand-supply ratio increased in all but the worst case scenario, but was unequally distributed between spatial units, with several areas being over- and some being under- or none-serviced in 2030. CONCLUSIONS Within the limitations of the underlying data and the required assumptions, this study expects an increasingly polarized ratio of dental services demand and supply in Northern Germany. Our estimation allows to assess the impact of different influence factors on demand or supply and to specifically identify potential challenges for workforce planning and regulation in different spatial units.