Disaster warning from the Turkish Dental Association: 'Dentists are fleeing the country, the profession is dying!'

It has become a common refrain among professional organizations and citizens complaining about the current problems and situation in the healthcare system; we are all familiar with sentences starting with “the system is clogged” or “the system has collapsed.” 

To the chain of problems in the healthcare system—ranging from appointment issues at hospitals to TUS (Medical Specialization Exam) results—the difficulties dentists have faced in recent years to sustain their profession have now been added. Last week, the Turkish Dental Association (TDB) issued a press release once again calling attention to long-standing issues and expressing their concerns, particularly regarding the period after 2028. 

In their statement titled “We want justice in employment quotas, not unemployment,” they summarize the current situation as: “There is profiteering, there are too many faculties, there are no professors, no infrastructure, no education, no future...” 

The press release points out that dentists are fleeing the country due to anxiety about the future and feelings of burnout caused by negative working conditions, stating, “We will face a complete disaster scenario for the period after 2028.”

A “disaster” warning in any link of the healthcare system is not an issue to be normalized or ignored. But unfortunately, the central authority's approach to such vital issues is, as has become traditional, to not listen to professional organizations! 

Playing the 'three monkeys' to professional organizations

Authorities, who accept meeting requests from professional organizations with great difficulty, often remain indifferent to the pages of reports presented to them. When existing problems are ignored, they are effectively “denied.” 

Yet, all potential problems predicted regarding the healthcare system to date have come true one by one over time. Precisely for this reason, it is difficult to understand why the words of industry representatives are not heeded and why doctors and dentists are not consulted in their own fields when decisions are being made. 

At the top of the dentists' agenda, which needs to be addressed urgently, are the newly opened faculties and the quota problem. They also have a series of demands for the effective use of public resources, the improvement of dental education, the preservation of the quality of oral and dental health services, the halting of emigration, and the protection of dental labor. 

According to the Health Workforce Targets and Health Education 2023 Projection Report prepared by the Ministry of Health in 2014, if the current situation regarding school quotas and student numbers continues, the supply of dentistry and pharmacy professions will exceed the need, and it is stated that by setting the total quota for dentistry at a maximum of 1,000 per year, a total of 38 thousand dentists would be reached by 2023, which would be sufficient. However, this projection by the ministry was already exceeded 2 years ahead of schedule in 2021 with 39,851 dentists. The total quota/new enrollment numbers in dental faculties in recent years are significantly higher than the quota numbers envisioned by the Ministry.

In the 2023/2024 period, this number increased even further, with the total quota/new enrollment reaching 11,254. 

50 thousand new dentists will graduate after 2028

The Turkish Dental Association's latest statement indicates that if the increase over the past 10 years continues, a complete disaster scenario will be faced after 2028, stating, “If student admissions to dental faculties are stopped and current students graduate within five years, approximately 50 thousand new dentists will graduate within five years.”

So, what awaits dentists if this increase is not stopped? 

Following the press release, I sought the opinion of Emel Eroğlu Uzer, Secretary General of the Turkish Dental Association, who first states that this increase in student quotas contradicts the article included in the 2024-2028 Twelfth Development Plan, and adds:

“Unfortunately, this increase does not seem to be stopping. The issue is not being looked at within a planning framework. They are trying to save the day with populist approaches.”  

As highlighted in the press release; “It clearly contradicts articles 682.3 and 711.1, which include the goal of increasing the quality of education in health professional groups, especially medicine, dentistry, and pharmacy, ensuring standards across the country by supporting curricula in specialty training with IT infrastructure, creating sufficient and qualified labor in every field in accordance with the future needs and conditions of the health sector and considering the country's needs, and ensuring that Higher Education quotas are determined in proportion to the capacities of universities, in line with the current situation and projections of sectoral labor supply and demand, and by taking regional needs into account,” it is stated. 

We go to the dentist once every two years!

Compared to developed countries, our rate of visiting the dentist is very low. For example, while the frequency of a person visiting a dentist in developed countries is 5 times a year, in our country, a dentist is visited only once every two years. 

Explaining that demand in the relevant professional field is considered the fundamental element in manpower planning, Emel Eroğlu Uzer explains the reason for this as follows: 

“Manpower planning has certain criteria. When viewed according to scientific criteria, it is seen that half of the population has not visited a dentist at all in the last year for manpower planning. Access to service is related to health culture. Unfortunately, our people do not have this habit. Most importantly, it is the utilization rate of the service. As a social state, you must facilitate the public's access to health.”

The number of appointments is constantly being increased

Reminding that dental education is one of the most expensive forms of education, Uzer emphasizes that the current system focuses on curative services, but the correct approach lies in supporting and developing preventive health services. Uzer summarizes the mistakes in the system and the point to which the problems have brought their profession as follows: 

“The labor force of physicians is so high... The number of dentists is known, but the number of appointments is constantly being increased. Nearly 13 thousand dentists work in the public sector. There are around 154 centers, but it should be at least double that. 

What the service provided is is very important. There is no equivalent for preventive oral and dental health services in the public sector. It is not possible to solve the problem only with treatment services. You are making the manpower work in vain. 

The health workforce is being devalued. They say, 'If they leave, let them leave, we will continue with new graduates,' but the background of this does not even consider what a great effort it is for the country's resources to train a doctor, a dentist, or a pharmacist.”

Young dentists are forced to work below minimum wage!

One of the most important issues highlighted in the Turkish Dental Association's statement is the devaluation of labor as graduates in excess of need enter professional life in increasing numbers. 

In the statement, which emphasizes that dentists are squeezed between unemployment and low wages: “Our young colleagues are unfortunately being forced by capital to work for even less than the minimum wage, almost like 'cheap labor intermediate staff.' Due to negative conditions in working life, the anxiety about the future they rightfully feel, and feelings of burnout, they are fleeing the country. So much so that there is data that can easily say this flight will continue to increase every year,” it is said. 

The number of those emigrating abroad is increasing exponentially

The number of those receiving the 'good standing certificate' issued by the TDB for dentists going abroad for education and work purposes is increasing every year. So much so that while it was recorded that only 6 dentists applied for a good standing certificate in 2015, the number of requests has increased exponentially in recent years. This number doubled in 2023 compared to the previous year, reaching 416 people. In just the first 4 months of 2024, 158 dentists have applied for a good standing certificate for the purpose of working abroad.