A modern medical system including dentistry was introduced to Taiwan during the Japanese colonial period (1895–1945). Since 1896 (Meiji 29), the first dentist (Dr. Sakai Chiyomatsu) applied for the permission of government to open his dental clinic on the main street in Taipei City, starting the model of legal management of dentists in Taiwan.1 These included promulgating the dentists law, establishing the legal status of dentists in Taiwan, and clearly stipulating that it is illegal for people who are not qualified as dentists but engage in dental services. However, the post-war government's medical legal system not only did not have a separate dentists law, but also did not include dentists under the management of Physicians Act, resulting in a major obstacle to the development of dentistry in Taiwan in those days. After many years of hard work by the dental profession, dentists not only have returned to their legal status, but also have launched a comprehensive system of dental specialists in recent years.2,3 In this article, we explored an overview of the dental specialist system in Taiwan.
During June 2023, we searched for all dental specialties related to law level and regulation level in Taiwan through the websites of the Ministry of Health and Welfare and related dental associations to record their basic information. The legal approval date of Physicians Act for dentists and regulations for various dental specialists, related government-recognized dental specialist associations and their founded time, and the numbers of approved dentistry-related certificates in Taiwan in the past 5 years (from 2018 to 2022) are shown in Table 1. At the law level, Taiwan's new Physicians Act passed the bill incorporating dentists in 1967 and implemented it in 1975, restoring the management of dentists at the legal level. The nationwide dental academic organization (Taiwan Association for Dental Sciences, TADS) was established in 1977. However, its predecessor was an informal dental society established in 1950 by the dental school of Military University. Currently, there were 16,431 dentists with an average of 465 new-entry dentists per year in the past five years. At the level of regulations, in addition to implant dentistry of which the legal process has not yet completed, there was a comprehensive dental specialist system with 10 specialties, including oral and maxillofacial surgery, oral pathology, orthodontics, pediatric dentistry, endodontics, prosthodontics, operative dentistry, periodontics, family dentistry, and special needs dentistry. Among them, usually one specialty has a government-recognized dental specialist association that obtains authorization to manage its own specialty. However, the specialty of special needs dentistry has two government-recognized associations (Table 1). The 1980s was the peak period for the establishment of dental specialist associations (n = 5), followed in a descending order by the 1990s (n = 4) and 2000s (n = 2). The first three dental specialties completed the legal process during the 10-year period from 1999 to 2009, while after 10 years of waiting, the last 7 dental specialties completed the legal process during the 3-year period from 2019 to 2022. Oral and maxillofacial surgery is the earliest dental specialty to complete the legal process (1999). It is the first dental specialty and the 23rd specialty in Taiwan medical system. Its society is also the earliest established dental specialist association (1986). For the time interval from founded time to legal approval date, oral and maxillofacial surgery took 13 years to complete the legal process. However, oral pathology took 12 years (from 1989 to 2001) to complete the legal process. Among the other 8 dental specialties, the time interval ranged from 20 years (special needs dentistry) to 34 years (periodontics) to complete the legal process. The total cumulative number of approved certificates of all dental specialists was 5743 till the end of 2022. Among them, family dentistry had the largest number of specialists (2169, 37.77%), followed in a descending order by orthodontics (786, 13.69%), special needs dentistry (628, 10.94%), periodontics (514, 8.95%), and oral and maxillofacial surgery (463, 8.06%), while oral pathology had the fewest number of specialists (83, 1.45%).
Table 1.
The legal approval date of Physicians Act for dentists and regulations for various dental specialists, related government-recognized dental specialist associations, and the numbers of approved dentistry-related certificates in Taiwan from 2018 to 2022.
| Dental specialty | Legal approval date | Government-recognized dental specialist association | Founded time | Time interval | Numbers of approved certificates |
||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| 2018 | 2019 | 2020 | 2021 | 2022 | Totalb | ||||||
| Law level | |||||||||||
| 1 | Dentist | September 11, 1975 | Taiwan Association for Dental Sciences (TADS) | 1977 | – | 471 | 471 | 414 | 521 | 446 | 16,431 |
| Regulation level | |||||||||||
| 1 | Oral and maxillofacial surgery | May 14, 1999 | Taiwanese Association of Oral and Maxillofacial Surgeons (TAOMS) | 1986 | 13 | 9 | 21 | 16 | 9 | 23 | 463 |
| 2 | Oral pathology | May 30, 2001 | Taiwan Academy of Oral Pathology (TAOP) | 1989 | 12 | 0 | 0 | 0 | 1 | 2 | 83 |
| 3 | Orthodontics | August 6, 2009 | Taiwan Association of Orthodontists (TAO) | 1988 | 21 | 25 | 26 | 30 | 46 | 36 | 786 |
| 4 | Pediatric dentistry | October 6, 2019 | Taiwan Academy of Pediatric Dentistry (TAPD) | 1992 | 27 | – | – | 323 | 32 | 30 | 385 |
| 5 | Endodontics | February 4, 2021 | Academy of Endodontology, Republic of China (AE, ROC) | 1991 | 30 | – | – | – | 280 | 40 | 320 |
| 6 | Prosthodontics | July 2, 2021 | Academy of Prosthetic Dentistry, Republic of China (APD, ROC) | 1989 | 32 | – | – | – | 240 | 19 | 259 |
| 7 | Operative dentistry | July 2, 2021 | Taiwan Academy of Operative Dentistry (TAOD) | 1995 | 26 | – | – | – | 120 | 16 | 136 |
| 8 | Periodontics | August 11, 2021 | Taiwan Academy of Periodontology (TAP) | 1987 | 34 | – | – | – | – | 514 | 514 |
| 9 | Family dentistry | November 1, 2021 | Association of Family Dentistry, Republic of China (AFD, ROC) | 1998 | 23 | – | – | – | – | 2169 | 2169 |
| 10 | Special needs dentistry | January 19, 2022 | Taiwan Association for Disability and Oral Health (TADOH) | 2002 | 20 | – | – | – | – | 628 | 628 |
| Specialist Association of Taiwan Special Care Dentistry (TOPSa) | 2005 | ||||||||||
| 11 | Implant dentistry | Legal process not yet completed | Taiwan Alliance of Dental Implant Associations (TADIA) | 2020 | – | – | – | – | – | – | – |
| Taiwan National Association of Dental Implantology (ADI, ROC) | 2021 | ||||||||||
| Total | 34 | 47 | 369 | 728 | 3477 | 5743 | |||||
The time interval is the number of years from the founded time of a dental specialist association to the legal approval date of its specialty.
The abbreviation is derived from its original association name (Taiwan Oral Health Association for People of Special Needs).
This refers to the total number of member dentists of the Taiwan Dental Association (TWDA) or the cumulative numbers of approved certificates of various dental specialists till the end of 2022.
According to the results, we found that post-war dental profession of Taiwan spent 30 years fighting for restoration of the legal status of dentists. However, after another 46 years of professional development until 2021, a comprehensive dental specialist system was finally born in Taiwan. It is a pity that this may also be an unbalanced dental specialist system. Oral pathology is an important discipline for constructing the basic professional knowledge of dentists, so it became a legal specialty of dentistry at a very early stage.2 Although we could estimate that in Taiwan, one-third of dentists may have the certificates of at least one dental specialty, it is certain that oral pathology is still the dental specialty with the fewest number of specialists. On the other hand, since Taiwan implemented the National Health Insurance (NHI) in 1995, the career of dentists has been favored by the social value system, which has accelerated the growth of the number of dentists in Taiwan.4,5 Currently, the number of dentists per 100,000 people has reached 70.6, and there are problems of excess manpower and uneven geographical distribution of dentists. Therefore, a full contributing manpower structure of the dental profession must be constructed. It is imperative that the policy for dental manpower planning must effectively control the growth of the number of dentists, and promote the balanced growth of various dental specialists, which subsequently can meet the sound development of future dental profession.
Conflicts of interest
The authors have no conflicts of interest relevant to this article.
Acknowledgments
None.
Contributor Information
Yin-Lin Wang, Email: wil1019@ntu.edu.tw.
Chun-Pin Chiang, Email: cpchiang@ntu.edu.tw.
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