Mapping the prosthodontic workforce in Saudi Arabia: Patterns, training backgrounds, professional ranks, and regional distributions

Abstract

Purpose

This study aimed to provide a comprehensive national overview of the prosthodontic workforce in Saudi Arabia, focusing on its demographic composition, educational background, geographic distribution, and workforce trends. The findings are intended to support policymakers in postgraduate education planning, and equitable access strategies to prosthodontics care.

Materials and methods

A retrospective cross-sectional analysis was conducted using official data obtained from the Saudi Commission for Health Specialties (SCFHS) as of May 2025. The dataset included all registered practicing prosthodontists across Saudi Arabia. Key variables included gender, nationality, professional classification, practice region, and postgraduate training background. The prosthodontist-to-population ratio was calculated based on the 2024 national census data. Descriptive statistics were used to analyze the characteristics of the prosthodontic workforce.

Results

A total of 1,542 prosthodontists were identified across Saudi Arabia, resulting in a national ratio of 4.37 prosthodontists per 100,000 population. The workforce was predominantly male (65.8%), with females representing 34.2%. Non-Saudis accounted for 56.5% of the workforce, while Saudis made up 43.5%. Most prosthodontists were located in major metropolitan areas, with 34.1% practicing in Riyadh, 24.6% in Makkah, and 11.8% in the Eastern Region. The most common countries of postgraduate education were Egypt (29.3%), Saudi Arabia (27.3%), India (9.0%), and the United States (7.2%). The workforce was almost evenly divided between the public sector (48.3%) and the private sector (47.8%).

Conclusion

Saudi Arabia has witnessed steady growth in its prosthodontics workforce, marked by increased training capacity, diverse educational backgrounds, and encouraging participation of female practitioners. Despite this progress, challenges remain in achieving balanced gender representation, equitable regional distribution, and consistency in training standards. These findings highlight the importance of thoughtful workforce planning and the need to reassess classification systems and align training pathways with internationally recognized benchmarks. Such efforts will be essential to ensure high-quality, inclusive, and sustainable prosthodontics care across all regions.

Introduction

Prosthodontics is a fundamental discipline in restorative dentistry, dedicated to the diagnosis, treatment planning, rehabilitation, and maintenance of oral function, comfort, appearance, and health in patients with clinical conditions associated with missing or deficient teeth (“The Glossary of Prosthodontic Terms 2023: Tenth Edition” 2023). The scope of prosthodontics extends beyond conventional removable and fixed dental prostheses to include maxillofacial prosthetics and implant-supported restorations (Cooper 2009). Due to its complex and multidisciplinary nature, prosthodontics requires advanced training and a high level of clinical precision (Hudson 2014). In Saudi Arabia, this specialty is particularly critical, as prosthodontic procedures account for a significant proportion of dental malpractice claims, underscoring the necessity for a well-trained, regionally distributed, and academically diverse workforce (Alsaeed et al. 2022).

The global demand for prosthodontic services is anticipated to rise due to several converging factors (Douglass et al. 1988), including increased life expectancy (Papaspyridakos et al. 2014), greater public awareness of esthetic and functional oral rehabilitation (Suganna et al. 2023), and the widespread adoption of implant-based therapies (Alghamdi and Jansen 2020). In Saudi Arabia, these trends are further compounded by a rapidly growing population and a high burden of edentulism and complex restorative needs (Wirayuda et al. 2023, 1980–2020). Despite these evolving demands, national-level data detailing the prosthodontic workforce—its demographics, distribution, and educational background—remain scarce. In contrast, other specialties such as periodontics (Alqahtani and Alshehri 2024) and endodontics (Alqahtani et al. 2025) have been the focus of recent workforce analyses that highlight substantial regional disparities and the need for strategic workforce planning.

Globally, studies have identified key challenges in specialist dental workforce planning, including imbalances in urban–rural distribution, an aging workforce, and variability in training standards (Luo et al. 2021). For instance, in the United States, the ratio of prosthodontists per 100,000 people remains low compared to general practitioners (Nash and Benting 2019) and access to prosthodontic services is disproportionately centered in metropolitan areas.(Waldman 1998, 1987–95) Similar trends have been observed in countries such as Australia (MacGregor 1989) United Kingdom (Jo et al. 2021) and New Zealand (MacGregor 1989). However, the applicability of these findings to the Saudi context is limited by differences in healthcare systems, licensing frameworks, and postgraduate education pathways. Thus, country-specific data are essential to accurately assess the current landscape and project future needs.

Moreover, the diversity in educational pathways among prosthodontists in Saudi Arabia—many of whom are trained in North America, Europe, or locally accredited programs—raises critical questions about clinical competence standardization, curriculum alignment, and the impact of training location on professional integration and academic advancement. Understanding these dimensions is crucial for informing national policy initiatives aimed at enhancing postgraduate dental education, achieving equitable service distribution, and promoting local self-sufficiency in specialist training.

In light of these considerations, the objective of this study is to provide a comprehensive national analysis of the prosthodontic workforce in Saudi Arabia, focusing on its size, gender distribution, regional deployment, and educational qualifications. To the authors’ knowledge, this is the first national-level analysis focused exclusively on prosthodontists in Saudi Arabia. The findings are expected to provide actionable insights for policymakers, academic leaders, and healthcare planners striving to align specialist dental workforce capacity with evolving population needs and to ensure the sustainability and equity of prosthodontic care delivery across the Kingdom.

Materials and methods

This retrospective, cross-sectional study was designed to evaluate the demographic characteristics, geographic distribution, professional ranks, and educational backgrounds of prosthodontists practicing in the Kingdom of Saudi Arabia. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines to ensure clarity, transparency, and methodological rigor. Ethical approval for the study protocol was obtained from the Institutional Review Board at King Abdullah International Medical Research Center (IRB# NRR 24/110/12).

Data for this study were obtained from the Saudi Commission for Health Specialties (SCFHS), the national authority responsible for licensing healthcare professionals across all health specialties in Saudi Arabia. The SCFHS database included all prosthodontists registered and actively practicing in the Kingdom of Saudi Arabia as of May 2025. The extracted dataset comprised information on each prosthodontist’s gender (male or female), nationality (Saudi or non-Saudi), professional classification (consultant, senior registrar, registrar, or training resident), region of practice (based on Saudi Arabia’s 13 administrative regions). An ‘Unknown region’ category was also included for prosthodontists whose practicing location was not specified in the registry. Educational background was categorized by the country of postgraduate training into local (Saudi Arabia) and international (e.g., USA, Canada, UK, Egypt, etc.) institutions. To ensure data integrity and relevance, only fully licensed individuals recognized by the SCFHS as prosthodontists were included in the study. Individuals who were licensed under different specialties, classified as general dentists, or whose classification or geographic location could not be verified were excluded from the analysis.

To quantify access to care, the prosthodontist-to-population ratio was calculated using the most recent Saudi national census data, which estimated the total population at 35.3 million in 2024 (“9b71e303-5fd9-19cb-9913-850a9d521639.Pdf,” n.d.). The number of licensed prosthodontists was divided by the total population and multiplied by 100,000 to derive a standardized ratio for interregional and international comparison. Data were processed using Microsoft Excel 2016.

Results

As of May 2025, a total of 1,542 prosthodontists were identified in Saudi Arabia. The majority were male (65.8%) and non-Saudi (56.5%) (Table 1). Regionally, practitioners were concentrated in Riyadh (34.1%), Makkah (24.6%), and the Eastern Province (11.8%), aligning with urban population centers (Table 2; Fig. 1). Based on the 2024 national census estimate of 35.3 million people, the prosthodontist-to-population ratio was calculated to be 4.37 per 100,000, serving as a national benchmark for access to specialist care.

Table 1.

Distribuation of prosthodontists by gender and nationality

Gender	Saudi N (row %)	Non-Saudi N (row %)	Total N (row %)
Male	409 (40.34%)	605 (59.66%)	1014 (65.76%)
Female	261 (49.43%)	267 (50.57%)	528 (34.24%)
Total	670 (43.45%)	872 (56.55%)	1542

Table 2.

Prosthodontists concentrations per region

Regions	Total N (%)
Riyadh	525 (34.05%)
Makkah	379 (24.58%)
Eastern Proviance	182 (11.8%)
Asir	87 (5.64%)
Al-Qassim	85 (5.51%)
Al Madinah	76 (4.93%)
Unknown	48 (3.11%)
Jizan	34 (2.2%)
Tabuk	34 (2.2%)
Al Jawf	32 (2.08%)
Hail	21 (1.36%)
Najran	20 (1.3%)
Northern B	11 (0.71%)
Al Bahah	8 (0.52%)
Total	1542

Fig. 1.

Geographic distribution of licensed prosthodontists across the administrative regions of Saudi Arabia, stratified by gender

Regarding professional rank, registrars constituted the largest group (43.7%), followed by consultants (28.7%) and senior registrars (16.4%) (Table 3). Most registrars were non-Saudi, while consultants were predominantly Saudi males.

Table 3.

Prosthodontics workforce by professional rank and demographics

Rank	Saudi Male N (row %)	Saudi Female N (row %)	Non-Saudi Male N (row %)	Non-Saudi Female N (row %)	Total N (column %)
Consultant	216 (48.87%)	102 (23.08%)	90 (20.36%)	34 (7.69%)	442 (28.66%)
Senior Registrar	104 (41.11%)	84 (33.20%)	42 (16.60%)	23 (9.09%)	253 (16.41%)
Registrar Training	34 (5.05%)	26 (3.86%)	430 (63.89%)	183 (27.19%)	673 (43.64%)
Resident	50 (53.76%)	41 (44.09%)	1 (1.08%)	1 (1.08%)	93 (6.03%)
General Dentist/resident	5 (6.17%)	8 (9.88%)	42 (51.85%)	26 (32.10%)	81 (5.25%)
Total	409	261	605	267	1542

In terms of education, prosthodontists had trained in more than 30 countries, with the highest proportions from Egypt, Saudi Arabia, and India. Academic Master’s degrees were the most common qualification (38.9%), followed by board certifications and doctorates (Table 4).

Table 4.

Prosthodontists educational background training

Country	Count N (row %)
Egypt	452 (29.31%)
Saudi Arabia	421 (27.3%)
India	138 (8.95%)
United States	111 (7.2%)
Syria	104 (6.74%)
United Kingdom	68 (4.41%)
Others	68 (4.41%)
Canada	57 (3.7%)
Jordan	36 (2.33%)
Sudan	22 (1.43%)
Germany	19 (1.23%)
Scotland	16 (1.04%)
Lebanon	16 (1.04%)
Pakistan	14 (0.91%)
Total	1542

Graduation trends over the past three decades show a steady increase in new graduates, particularly after 2010 (Fig. 2). While the proportion of female graduates has risen, especially in the last five years, women remain underrepresented overall, accounting for 43% of recent graduates but only 34.2% of the workforce (Fig. 3).

Fig. 2.

Registration trends of total prosthodontists in Saudi Arabia from 1990 to 2025

Fig. 3.

Registration trends of female and male prosthodontists in Saudi Arabia from 1990 to 2025

Finally, workforce distribution by employment sector revealed a near balance between the public (48.3%) and private (47.8%) sectors, with only a small proportion unclassified or unemployed.

Lastly, analysis of employment sectors revealed a nearly equal distribution of prosthodontists between the public sector (n = 745, 48.3%) and private sector (n = 737, 47.8%), with a small portion (n = 23, 1.5%) being unemployed or unclassified.

Discussion

This study provides a comprehensive overview of the prosthodontic workforce in Saudi Arabia, revealing a prosthodontist-to-population ratio of 4.37 per 100,000. This figure surpasses those reported in countries such as the United States (approximately 1.5 per 100,000),(“Facts & Figures | American College of Prosthodontists,” n.d.) the United Kingdom (1.3 per 100,000) (Jum’ah et al. 2019), and Canada (2.1 per 100,000) (Harle 1993). Within the national context, prosthodontists outnumber other dental specialties, prosthodontists are higher in number compared to endodontists (n = 1336) (Alqahtani et al. 2025) and periodontists (n = 700) (Alqahtani and Alshehri 2024). The corresponding endodontist-to-population and periodontist-to-population ratios are 4.1 per 100,000 and 2.2 per 100,000, respectively (Alqahtani and Alshehri 2024), (Alqahtani et al. 2025). These differences may reflect historical variations in training program availability, clinical service priorities, and evolving patient expectations. Nevertheless, the growing complexity of restorative needs and the widespread adoption of implant-based therapies reinforce the need for a well-distributed prosthodontic workforce to ensure access to specialized, high-quality care across all regions.

Gender disparities within the prosthodontic workforce remain evident, with males comprising a larger proportion of practitioners compared to females—a trend that mirrors patterns observed in other countries, including the United States (Phasuk et al. 2020; Afshari et al. 2017; Kongkiatkamon et al. 2010). This imbalance may stem from multiple factors, including historical underrepresentation of women in surgical and restorative specialties, limited access to mentorship, and sociocultural or logistical barriers related to the geographic concentration of postgraduate programs in major urban centers. Nevertheless, a gradual increase in the number of female prosthodontists, particularly among recent graduates, suggests a positive shift toward gender balance. Encouraging further female participation may require targeted strategies such as expanding training opportunities in underserved regions, supporting flexible training pathways, and promoting mentorship and leadership programs for female dental professionals. In terms of professional classification, most practitioners are ranked as registrars, primarily due to holding a Master’s degree—the most prevalent qualification among the cohort. A contributing factor is the recent policy by the Saudi Commission for Health Specialties (SCFHS) that allows Master’s degree holders to challenge the board examination directly, which may explain why many have not yet progressed to consultant-level ranks. Geographically, the workforce remains heavily concentrated in the three major provinces—Riyadh, Makkah, and the Eastern Region—reflecting population distribution and healthcare infrastructure availability; similar urban-centric trends are reported internationally (Vargas et al. 2002; Gupta and Miah 2024). Policymakers may consider strategies to promote a more balanced geographic distribution of prosthodontists across the Kingdom to ensure equitable access to specialized care.

The diversity in educational backgrounds among prosthodontists practicing in Saudi Arabia has led to significant variability in clinical training philosophies, competencies, and ultimately, scope of practice. In North America, for example, prosthodontic training programs often require residents to gain competency in surgical implant placement, recognizing the growing integration of surgery into prosthodontic care (Barias et al. 2013; Prosthodontic Training Standards, n.d.). Similarly, programs in the United Kingdom, such as those outlined in the General Dental Council’s Prosthodontic Specialty Training Curriculum, also incorporate implant surgery and emphasize laboratory-based training (Fleming et al., n.d.). Furthermore, the majority of the U.S. and Canadian programs integrate digital dentistry workflows and CAD/CAM systems early in residency, ensuring that trainees are familiar with contemporary prosthodontic technology (Wojnarwsky et al. 2017). In contrast, prosthodontic residency programs in many European and Middle Eastern countries maintain a more traditional focus on fixed and removable prosthodontic rehabilitation, often excluding surgical training from their core curricula. Laboratory work may be underrepresented, and digital exposure is frequently limited or elective (Alnafaiy et al. 2024). This disparity in training emphasis—from surgical and technological proficiency to prosthetic-only focus—results in notable differences in the clinical autonomy, treatment planning approach, and interdisciplinary collaboration capabilities among prosthodontists in Saudi Arabia. Such variation poses challenges for standardizing clinical expectations and developing unified national benchmarks for postgraduate prosthodontic competency.

Additionally, a significant portion of the workforce—nearly 30%—consists of Egyptian-trained prosthodontists. This trend likely reflects Egypt’s educational structure, where fixed and removable prosthodontics are taught as separate specialties. However, within the Saudi classification system, graduates from either track are registered under the single title of “prosthodontist.” As a result, some practitioners may have training limited to one sub-specialty while holding the same professional classification as comprehensively trained colleagues. To ensure consistency and uphold the quality of care, it is important to establish unified classification policies that recognize comprehensive training aligned with internationally accepted standards set by leading countries in the field.

It is important to acknowledge potential limitations in the classification accuracy of the dataset. In some cases, prosthodontists who completed their postgraduate education in the United States may appear under the Canadian board due to obtaining Royal College certification, potentially obscuring their actual training background. Similarly, practitioners who completed their education abroad may later have qualified through the Saudi board examination, leading to their classification as locally trained specialists. These overlaps may result in partial misrepresentation of training origins, particularly for internationally educated prosthodontists. Such classification inconsistencies highlight the need for a more standardized and transparent tracking system within the national registry to enhance the accuracy of workforce analytics and support data-driven policymaking.

The significant increase in prosthodontic graduates over the past decade underscores the importance of forward-thinking workforce planning. The rise from fewer than 100 graduates in the early 2000 s to over 800 since 2016 represents an eightfold increase, reflecting both the expansion of training capacity and the evolution of policies related to classification and licensure. While this growth reflects progress in strengthening the specialty, it also presents an opportunity to ensure that workforce expansion continues to align with national oral health priorities. To support balanced workforce development and ensure continued opportunities for professional growth, future planning would benefit from being informed by population-based needs, structured certification frameworks, and alignment with internationally recognized standards. Such an approach can contribute to sustaining high-quality patient care, enhancing specialist readiness, and promoting the long-term stability and advancement of prosthodontic services across the Kingdom.

This study is based on workforce registry data obtained from the Saudi Commission for Health Specialties (SCFHS), which, while comprehensive, may not fully reflect real-time practice activity or employment status changes that occur between reporting periods. The cross-sectional design limits causal inferences and only provides a snapshot of the workforce at a specific time point. Additionally, the classification of practitioners relies on the credentials recorded in the SCFHS system, which may not always capture ongoing professional development, dual specialties, or clinical subspecialization. Regional distribution patterns should also be interpreted with caution, as the registry does not account for part-time practitioners, multiple practice locations, or inactive licenses. Despite these limitations, the dataset remains the most authoritative source for analyzing national prosthodontic workforce trends in Saudi Arabia.

Conclusion

The findings of this study reveal critical trends and disparities within the prosthodontic workforce in Saudi Arabia, including a relatively high specialist-to-population ratio, notable gender imbalances, and substantial variation in educational backgrounds. While the overall growth in prosthodontist numbers may reflect expanded postgraduate training capacity, it also raises concerns regarding consistency in clinical competencies. These insights emphasize the urgent need for coordinated national workforce planning, informed by both current service demands and projected future needs.

To address these challenges, we recommend the following actions:

1. Promote the inclusion of female practitioners in prosthodontics through targeted scholarships, flexible training pathways, and structured mentorship programs;

2. Establish clear and tiered classification criteria to ensure alignment between clinical responsibilities and training backgrounds;

3. Introduce regional workforce incentives to support the equitable geographic distribution of prosthodontists, particularly in underserved areas;

4. Standardize national postgraduate training curricula, ensuring consistent exposure to surgical, digital, and laboratory competencies;

5. Implement a centralized workforce monitoring system to track specialist growth, forecast regional demands, and support sustainable capacity planning.

Author contributions

Abdulrahman Almalki: Conceptualization, supervision, drafting.

Hussam Alqahtani: Data collection, methodology.

Adel Alenazi: Analysis, literature review.

Fahad Alkhtani: Data curation, validation.

Ali Robaian: Visualization, technical support.

Ramzi Althubaitiy: Statistics, review.

Data Availability

The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Declarations

Ethical considerations

The data were legally obtained from the authorized national regulatory body in Saudi Arabia. All data were received fully anonymized, with no identifiable personal information included. Data confidentiality was maintained throughout the analysis in accordance with ethical standards.