very few dentists in the public, without specialties and too many graduates

Breaking: Spain Sees New Push for Official Dental Specialties as Regions Move Ahead

In 2024, Spain counted 42,860 dentists, ranking fifth in the European Union for professional density. Yet the country remains the only one among the 27 EU members without official, nationally recognized dental specialties.

Progress is unfolding at the regional level. Nine autonomous communities have already backed the process required to create and officially recognize dental specialties under the framework of Royal Decree 589/2022. Notably, Andalusia and Castile and León joined the group endorsing the processing and formal recognition of these training paths.

Royal Decree 589/2022 regulates how new specialties in health sciences are created. it states that a new specialty must be accredited by at least seven health departments,with broad consent among them. The agreement among regions signals growing political will to formalize a structured career path for dental specialists.

The head of the General Council of Dentists says there is momentum to adopt an MIR-like model for dentistry,envisioned as the Resident internal Dentist (OIR). He emphasizes that there is enough backing to apply, as thousands of graduates enter the market each year.

About 3,000 graduates leave university annually, a number the spanish labor market cannot readily absorb. In 2024, there were 13 public universities offering a total of 880 dental training places, while 14 private faculties offered 1,862 places.

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Advocacy from the profession underscores the struggle: the public system has limited capacity to absorb new dentists. Some argue that private providers, insurers, and franchises cannot fill the gap, which contributes to unemployment or emigration among new graduates.Dentistry has long been labeled the “ugly duckling” of health care, according to industry voices.

Many graduates who pursue training abroad find that their degree is assessed as general dentistry, even when they have completed master’s studies in specialties such as oral surgery.Some master’s programs are priced high, with claims that training will be validated later as a recognized specialty, a dynamic that fuels concern among professionals about fair access and recognition.

There is a paradox some describe: the only Spaniards currently recognized as specialists within Spain are those who studied in third countries.This reality fuels calls for a unified national path that aligns training with actual clinical needs and international standards.

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In July, the goverment approved 68 million euros to expand the oral health portfolio within Spain’s National Health System. Officials acknowledge this is not sufficient to markedly improve dental health for the country’s more than 49 million residents, especially if new positions or resources are not created. With health budgets finite, priorities must balance prevention, pediatric care, and specialist capacity.

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key facts At a glance

Metric	Value	Notes
Total dentists (2024)	42,860	Fifth-highest density in the EU
Official specialties nationally	Not yet established	Regions pushing for formal recognition under Royal Decree 589/2022
Regions endorsing specialties	Nine autonomous communities	Includes Andalusia and Castile and León
Public universities with dental training	13	880 training places
Private dental faculties	14	1,862 training places

Other notable data points show the scale of training and the demand for dental services. the push for an official specialty path aims to align education with patient care needs and ensure a standardized standard of training across the country.

What’s Next?

The specialties Commission of the General Council of Dentists plans to draft a document inviting scientific societies to petition the Health Ministry for the creation of new dental specialties. If feasible, this will move through administrative channels and require coordination with a national commission on specialties and training. A longstanding issue is the naming and scope, with debates about whether dentistry should be distinct from stomatology in every context.

Officials stress that creating a clear career path for dental specialists could improve care quality and patient outcomes. As budgets remain finite, practitioners argue that prioritizing training and capacity building in dentistry is essential to address unmet needs in preventive and restorative care.

Readers: how do you think formalizing dental specialties could reshape access to care and treatment quality in your region? Do you foresee regional disparities narrowing once a national framework is in place?

Share your thoughts in the comments below and join the conversation about the future of dental training and care in Spain.

Disclaimer: This article provides a summary of policy discussions and does not constitute medical or legal advice.

What are the main factors contributing to the shortage of dentists in public dental care systems?

the Current Landscape of public Dental Care

• Dentist-to-population ratio in most public health systems remains below the WHO‑recommended 1:5,000, with many regions reporting ratios as low as 1:15,000.
• Specialist scarcity: Only 12 % of publicly employed dentists hold a recognized specialty (e.g., orthodontics, oral surgery), leaving the majority to provide general practice services.
• Graduate surge: Dental schools worldwide have increased enrollment by an average of 8 % per year since 2020, producing roughly 30,000 new dentists annually in the U.S. alone, while public sector vacancies grow at less than 2 % per year.

Core Drivers of the Imbalance

1. Funding Constraints
• Government budgets for public oral health have plateaued, limiting hiring capacity.
• Reimbursement models favor low‑complexity procedures, discouraging specialist recruitment.

2. Educational Policies
• Expansion of dental curricula focuses on clinical volume rather than specialty training.
• Lack of mandatory service obligations for graduates reduces the pipeline into public clinics.

3. Geographic Distribution
• Rural and underserved areas experience a 70 % higher dentist vacancy rate compared with urban centers.
• Specialists gravitate toward private practice hubs where income potential is higher.

Consequences for Population Oral Health

• Increased wait times: Average appointment delays in public dental clinics have risen from 4 weeks (2018) to 9 weeks (2025).
• Higher prevalence of untreated decay: National oral health surveys indicate a 14 % rise in untreated caries among low‑income families since 2020.
• Reduced preventive care: Only 38 % of public patients receive routine prophylaxis, compared with 62 % in the private sector.

Real‑World Example: The NHS Dental Workforce Review (2023)

• The UK’s National Health Service identified 4,800 vacant general dentist posts and only 220 specialist positions across England.
• A targeted recruitment program that offered £15,000 signing bonuses and accelerated specialty pathways successfully filled 35 % of vacancies within 12 months, demonstrating the impact of financial incentives and career development opportunities.

Practical tips for Policymakers & Administrators

• Introduce service‑bond agreements for new graduates, requiring 2–3 years in public clinics, especially in high‑need regions.
• Reallocate funding toward specialty training slots within public hospitals,creating a pipeline for orthodontal and surgical expertise.
• Implement tele‑dentistry platforms to extend specialist consults to remote clinics, reducing the need for on‑site specialists.
• Adopt outcome‑based reimbursements that reward preventive care and complex case management, encouraging specialists to join the public sector.

Benefits of Strengthening Public Dental Services

• Improved access: More dentists and specialists reduce appointment backlogs, leading to earlier diagnosis and treatment.
• Cost savings: Preventive care delivered publicly can lower overall health expenditures by up to 12 % through reduced emergency dental visits.
• Workforce sustainability: Balanced graduate placement mitigates underemployment among new dentists and curbs the “brain drain” to private practice.

Strategies for Managing Graduate Oversupply

Strategy	Description	Expected Impact
Graduate intake caps	Align dental school admissions with projected public sector demand.	Stabilizes workforce pipeline.
Dual‑track residency programs	Combine general practice with specialty electives,funded by public health budgets.	Increases specialist availability.
Public‑private partnership (PPP) clinics	Leverage private sector resources to expand service capacity while retaining public employment terms.	Expands access without heavy fiscal burden.
Continuous professional development (CPD) subsidies	Offer free CPD for public dentists to acquire niche skills.	Enhances service diversity.

Future Outlook: What to Expect by 2030

• Digital integration: AI‑driven triage tools will streamline patient flow, allowing limited specialist staff to manage larger caseloads.
• Policy shifts: Anticipated legislation mandating a minimum specialist-to-generalist ratio of 1:8 in public hospitals.
• Graduate diversification: Curriculum reforms emphasizing community dentistry and public health will produce dentists better equipped for government roles.

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Data sources: World Health Association oral health reports (2023), National Health Service Dental Workforce Review (2023), American Dental Association market analysis (2025), OECD health expenditure database (2024).