Table 2.

Implications of options of oral health personnel requirements for Ghana.

Options	Advantages	Disadvantages	Other Issues
Training more dentists	Possibility of having more qualified dentists in dental services (routine and specialist services). Increased numbers of qualified dental teaching staff in dental schools. Qualified staff for administration and research in oral health.	Further increases in initial costs. Increases in ongoing costs Higher probability of emigration (brain drain). Lack of teaching staff.	Need for greater numbers of teaching staff. General unwillingness to work in rural areas.
Training COHOs	Lower initial costs. Lower ongoing costs. Able to carry out preventive and promotive work (ART, pain relief). Higher probability of retention when sponsored and bonded by district assemblies. Could be retrained for utilisation in other medical fields. Possibility of obtaining external funding support.	Shortage of SRNs High emigration rates of SRNs currently. Uncertainty about willingness of SRNs to specialise in dentistry. Uncertainty about clear career pathway. Uncertainty about regulation. Uncertainty about supervision. Lack of teaching staff.	Uncertainty on plans for reintegration if it becomes necessary after 10–15 years of experimenting. Un-experimented previously. High professional antagonism.
Training Dental Therapists	Utilisation of dental therapists common in many parts of the world. Curriculum for training already available for adoption. Possibility of sharing teaching staff from other countries like Botswana, and South Africa Possibility of obtaining funding support from NGOs such as British Council and national governments e.g. Scandinavian or commonwealth countries. Possibility of training an initial batch in other countries to become teachers in dental therapy school in the future. Assurance of high quality right from the start. Relatively lower ongoing costs compared to dentists. Possible high retention rate in rural areas if sponsored and bonded by district assemblies.	High initial costs. Uncertainty about regulation. Uncertainty about supervision. Uncertainty about teaching staff.	Capable of undertaking majority of routine care provided by dentists (especially on children). Could effectively target the disabled and elderly especially in carrying out preventive procedures. Could be given skills to be able to train other primary health care workers such as teachers (e.g. in Botswana). Immediacy of getting numbers in training could be addressed by sending dental therapists abroad on pre-existing curriculum.