Belgium/Hainaut: fewer and fewer dentists in rural areas
1 per 1700. This is the ratio of dentists per inhabitant in the province of Hainaut, the worst-off province in Belgium. In some regions, such as the Borinage, there is even a shortage of dentists. Village dentists are disappearing, to be replaced by much larger dental centers. How can this situation be explained? And what can be done about it? We met dentists from Hainaut who are concerned about the future of dental care in the province.
In Sylvie Finet's La Bouverie practice, the telephone rings a lot. And it's Sylvie who picks it up, during her consultations or between two patients. "Ah yes, of course: I receive a lot of requests. This morning, for example, I had to turn away three people because I'm fully booked all day.I can't work until 11pm like some people do..."
Sylvie tries to stop around 7pm, but it's hard to keep up with the pace: days without breaks, with a feeling of pressure. "She explains that she sometimes does the impossible to find a place for "regular" patients. "But I can't do that for everyone . When it's people with no means of transport who call her, or very elderly people with reduced mobility, refusing an appointment hurts her heart. "I tell myself that without a dentist close by, to whom they can walk, these people will have to take the bus, and public transport, in the villages... it's not always well served!"
When Sylvie started her business, there were three of them working in La Bouverie. "And there was work for everyone". The last colleague retired in May. She spent a long time looking for a buyer. "Why? Well, for Sylvie, the first answer is very down-to-earth. Setting up on your own as a dentist is expensive. More expensive than before. "I don't think it's possible to set up a practice on your own for less than 100,000 euros these days.Computers have become more widespread, and equipment has evolved. It's much more expensive than it used to be..."
But it's not just about money. Working hours and quality of life also come into play, and can push young dentists to join larger dental centers. Sylvie often hears this argument. "The hours are not the same, depending on whether you work in a small practice or a large center. After 5 or 6 pm, most consultations stop. It's the same at the hospital!"
Add to this the temptation for young graduates to stay in Brussels, or at least in the big cities. Dentist Christophe Maillard spoke to us about this phenomenon. He is head of department at Epicura, a hospital grouping in Hainaut.
"For many people, moving away from the capital is a hindrance. It's more lively. A lot of them have done their training in a Brussels practice, and then they stay there and don't go back to the region. And that's a pity, because we end up here, in the hospital, with delays that aren't considerable, but can be significant!
To reduce delays, Epicura has set up its own dental center, the largest in Mons Borinage. A step in the right direction, says Christophe Maillard, even if he feels that incentives are lacking throughout the country. It's true that there's talk of this, but nothing has yet materialized for dentists. For her part, Sylvie Finet promotes the profession she loves so much. With her young patients. "From the age of 15 or 16, when they're in the chair, I ask them how they're doing at school, what they'd like to do later. I try to motivate them. But for the last two or three years, none of my young patients have told me they were tempted by dentistry". Passionate about her profession, Sylvie has no shortage of arguments. "I tell them that it's a fast-changing profession right now. We have new technologies, new materials, resins that we didn't have before, cosmetic dentistry is developing a lot..." For Sylvie, it's urgent to see "the next generation" arrive. "And not just for dentistry. For orthodontics. For more recent disciplines like endodontics: everyone is de-bored."