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This month, MED talks to the director general of dentistry at Saudi Arabia's Ministry of Health, Dr Mohammed Al-Rafee, about tackling the Kingdom's caries crisis and coaxing dental graduates into rural clinics.

What is the current state of public-run dentistry in Saudi Arabia?

We have around 2,000 dental clinics and 2,000 dentists, plus the dental staff under the Ministry of Health. They are spread across hospitals, specialist centres, simple clinics and primary health centres. Primary health centres are located in each neighbourhood in Saudi and we have around 1,200 of these. And the other 800 facilities would be specialised, secondary and tertiary dentists. These are inside hospitals or specialised dental centres that are located in the big cities.

Is there a shortage in Saudi's more rural areas?

In rural areas there are dentists. If the populated area is very small, there'll be one dentist, but if it is a bigger area there will be two or more. A small city will have lots of health centres... [and] these centres will offer specialist dental care. People in the smaller population areas will be referred to these centres for secondary or tertiary care.

Is it difficult to staff these smaller communities?

Whether it is in a small area or a big city, still your job is to be a general dentist. It will be the same in terms of equipment, in facility, materials and patients, but just a smaller population. If the dentist is a non-Saudi, which is very much the majority, we will offer a contract for a period of time, between one to five years. If it is a Saudi dentist, ideally we want them to have a higher education and become specialised. Therefore, we offer the opportunities for scholarships, either locally in Saudi or abroad, after working for a contracted period of time in these areas.

Some national graduates say they have struggled to secure a Ministry contract. Why is this?

Who comes first has the better chance. There is not much discrimination or barriers. There are dentists that are not open to moving to the smaller cities, because they do not want to leave their families, which is part of the culture. Maybe that was ok ten years ago, but not now. For the opportunities they have to look further afield. Saudi has 20 regions with their own main cities. Dental vacancies in these cities are not full, just those in Riyadh and Jeddah.

Has the increase in dental schools helped to improve the access to dental care across the Kingdom?

The Ministry of Higher Education is establishing more schools in the north and the south of Saudi. Within a few years there will be more dentists graduating in all areas of the Kingdom. It is our hope that the dentists who graduate from these new schools in the wider community will choose to stay where they have graduated and service those areas.

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