What Is Not Measured Cannot Be Planned: Public Dental Hygienists and Preventive Workforce Visibility in Oral Health Systems.

OBJECTIVES: To examine preventive oral health workforce visibility as a prerequisite for health-system planning, governance and accountability, using Spain as an illustrative case within a broader international perspective. METHODS: This Editorial synthesises current WHO workforce-monitoring frameworks, recent literature on preventive oral health workforce planning and previously reported Spanish administrative workforce data. No new dataset was generated or analysed. RESULTS: Workforce visibility should be distinguished from workforce sufficiency, service implementation and health outcomes. The relevant preventive workforce may include dental hygienists, dental therapists, oral health therapists and other locally recognised cadres. In Spain, 1207 publicly employed dental hygienists were previously identified, without representing the total practising workforce. A minimum monitoring set should include headcount and full-time-equivalent supply, population-adjusted density, geographical distribution, employment and contracting model, scope and activity, and integration into preventive programmes. CONCLUSIONS: Standardised monitoring aligned with the WHO National Health Workforce Accounts can strengthen assessment of health-system readiness while preserving the distinction between workforce measurement, service delivery and health outcomes.