Dr Aarti Sharma Kapila, Head – Quality, Clove Dental, gives a rundown on the dental care in India and elaborates on the opportunities and challenges for growth in this sector
Oral health care is an integral part of overall health, however this remains the most neglected part in our country because most of the people visit a dentist only when it is unavoidable. With a very high prevalence of dental disease (approximately 87 per cent), amongst the Indians population the oral healthcare sector is geared for a giant leap provided we generate awareness about dental disease and its consequences as well as about quality dental treatment facilities available in semi-urban and rural areas. Unlike countries abroad, dental treatment is not covered by any of the insurance companies in India. Hence, every dental treatment has to be paid by the individual which in itself is quite dampening as people generally believe that unless a ‘tooth is hurting’ why should they visit a dentist and ‘hurt their pockets.’
India’s healthcare sector is a combination of state-of-the-art healthcare providers to unregistered doctors and unqualified quacks. The situation is the same in dental healthcare too. In order to bridge this gap between healthcare providers and patients, there is a need for a massive increase in dental institutes and their productive capacity. In total there are 310 dental colleges in the country, of which only 40 are government, producing 30570 dentists annually. However, the problem arises when these dentists are not available to the masses at large and remain concentrated in certain regions, predominantly urban. This situation gives rise to problems such as poor quality of dental treatment, ambiguity in dentists qualifications, increased demand in terms of economy and sustainability.
Let’s examine the various aspects which characterise dental care in India with a SWOT analysis
Strengths
In Prime-minister Modi’s words, India’s population is its strength. Dental community should be able to use this staggering number to its advantage. The country has exceptional avenues for advanced learning and dental professionals can keep themselves abreast with the latest advancements to give their patients the best dental care possible. Further, dental treatment in India is affordable and there is a sharp rise in dental tourism, putting India and its dentists on the world map. The introduction of quality assurance certificates such as ISO, NABH by the Quality Control of India and formation of many dental corporates are helping in increasing the avenues for dentistry.
Weakness
The surprising question that looms large is, “Why does India still lag in channelising dental professionals?” According to WHO Health Statistics in 2004, dentist – population ratio in India was 1:30000, and in 2014, the ratio was 1:10000. In the year 2004, India had one dentist per 10000 people in urban areas and one dentist per 1.5 lakh people in the rural areas. This demand and supply disparity causes excessive burden on the dental professionals practicing in the rural areas, forcing them to sharply decrease the quality of dental treatment. Quality comes with a cost and when the treatment versus cost is not met, the axe falls on quality first.
In 2014, NHS England, tried to trace patients for blood borne disease and HIV treated by a dentist over a period of 32 years and had not followed proper sterilisation protocols. It was found that he was keeping dental equipment in the staff toilet. In India, we yet do not have a body to keep a strict check on the quality of dental professionals and their work ethics. The guidelines are revised from time to time but there is no audit team to check.
Government job vacancies for dental professionals are very less in number. Records show that only five per cent of graduated dentists are working in the government sector. The government also often lags in providing basic amenities to doctors working in rural areas. Most set ups are not fully developed or do not have a specialist and hence the patients have to run to urban areas.
Another major challenge is the number of post-graduate students or the seats available in dental colleges. The total number of post – graduate seats available are only around 3000 compared to each year pass outs of nearly 25000 dental graduates. This imbalance between graduates and postgraduates causes concentration of dental surgeons in the urban areas.
Opportunities
With multi-dental institutes and many private sector corporate chains emphasising on work ethics, many dental healthcare workers have a better opportunity. However, much needs to be done in this area. Evidence–based workforce plans, especially in the poorest and most fragile states, to motivate existing interns to work in the rural areas and prevent the mushrooming of dental set – ups in one particular area or city is the need of the hour. Such practices have the opportunity to provide a platform for young dental graduates and post graduates to be gainfully employed.
Threats
With the opening up of many private set ups, the threat of sustainability for each individual practice increases. However this does not affect a multi-practice chain as much. Also, the examination system and the process of dental selection in the country needs a few amendments. But with the government’s initiative of National Eligibility and Entrance Test (NEET), barriers in terms of quality will be met. The challenge will be for those who will not be able to meet the NEET criteria. However, the government will still not be able to prevent these fresh graduates from bee-lining towards the urban areas, until and unless they make working in semi urban and rural regions lucrative.
The Clove model
In order to provide quality dental treatment, many corporate dental chains have opened up in the country and are expanding rapidly so that every citizen rightfully gets dental treatment without any compromises. One such dental organization is Clove Dental which firmly stands and works on its three pillars namely Quality, Integrity and Ethics.
Chains like these work on strict disciplines of ethics and selects dentists from across the best institutes of the country. Each doctor further undergoes retraining. Each Clove Centre follows a very strict four-step sterilisation protocol which is also checked upon by a quality team of the organization and has a unique program of real time assessment of all dental treatments being done by its clinicians to prevent malpractice. With its collaborators from across the globe, Clove Dental provides latest dental treatment techniques. This has solved the problem of unemployment amongst dental professionals as similar chains offer the opportunity to be practice owners without any financial stake and the worries of administration issues that arise from running such a practice.