World Oral Health Day, which falls on March 20, carries the theme "Smile for Life" this year. Advancements in dental technology, equipment and the procedures they enable have ushered in a new era in dentistry, giving consumers a good reason to smile. Yet in India, large segments of the population still lack access to the benefits of modern dentistry. In fact, a significant portion of the population does not have access to any kind of dental care at all.
Oral healthcare in India
India's oral healthcare status demonstrates a great need for better education and more accessible services. The National Oral Health Programme notes that 95% of adults in India suffer from gum disease and 50% of our citizens don't use a toothbrush. The program also finds that 70% of children under the age of 15 have dental caries.
According to a 2013 report, "Utilization of dental care: An Indian outlook," published in the Journal of Natural Science, Biology and Medicine, the dentist-to-population ratio is 1:10,000 in urban areas but drops drastically to 1:150,000 in rural India. The report further notes that even in areas where the infrastructure for dental care exists, the utilisation of services can still remain low due to demographic, behavioural, socio-economic, cultural and epidemiological factors. Among these factors are fear of dental treatment and attitudes that assign lower importance to oral health. These factors indicate the need for greater education on the advancements that have made pain-managed dentistry more common and widely available. The general complacency toward oral health also highlights the need for better education on the link between oral health and general health.
"The National Oral Health Programme notes that 95% of adults in India suffer from gum disease and 50% of our citizens don't use a toothbrush... 70% of children under the age of 15 have dental caries. "
Where dental healthcare services are available, the standard of care is often not at par with dental care services in many developed countries. For example, it is still very easy to find dental clinics in which hygiene is not taken seriously. Unfortunately, consumers are not yet fully aware of the implications of receiving treatment in a clinic that does not take hygiene and sterilisation seriously. This will change.
A turn for the better
The Dental Council of India (DCI) sets guidelines for Indian dental clinics and dentists. An amended set of guidelines under the Clinical Establishment Act are expected to be approved by the government; they will improve the minimum standards required for dental clinics.
India has roughly 290 dental colleges and graduates 25,000 new dentists each year. According to the Indian Dental Association (IDA), India is home to more than 1,80,000 dental professionals, 35,000 specialists and 5,000 dental labs. The World Health Organisation estimates that 2,500 new dental clinics are needed every year to meet India's demand for dental services. But at around 40 lakh INR, the cost of setting up a clinic is prohibitive for most practitioners. India's greatest challenge is the lack of infrastructure. And within this challenge lies great opportunity.
The IDA notes that the growth rate for India's dental industry is around 30% per year. This is due in part to a growing awareness around health and dental care services, increasing incomes and a demand for better dental care facilities. India is now considered one of the largest single-country markets for overseas dental equipment and products, according to the IDA.
"From a public health perspective, the government can and should play a role in educating consumers. Dentists can also educate consumers. But to do this, they must first get consumers into their clinics."
The Global Child Dental Fund has issued a call for improved dental health in India. Within their call to action are four key action points: a national / state programme to provide dental care for the underserved and health education to improve dental health literacy; improvements in dental education at the undergraduate and postgraduate levels; a framework to allow senior members of the global Indian community to participate in improving India's dental health status; and mentoring programmes that link overseas Indian dentists with younger dentists based in India.
Under the Fund's Indian Strategy Project, a 2012 survey of Indian dentists found that 44% of the 1,194 dentists in the study described the oral health of the local population as "somewhat bad." When asked to identify the issues most in need of attention, the participating dentists identified gum disease, caries, oral health awareness and oral cancer as the most pressing issues. Gum disease was identified as the oral health condition that should become a primary focus in a national effort to raise awareness around oral health.
Seventy-eight percent of the dentists said it was "very important" that the Government of India direct funds toward community-based oral health initiatives in order to improve the oral health conditions of the population.
From a public health perspective, the government can and should play a role in educating consumers. Dentists in private practice can also educate consumers. But to do this, they must first get consumers into their clinics. In this respect, dental networks have an advantage. Their larger size enables them to achieve economies of scale that single, stand-alone clinics cannot achieve. As a result, these networks are in a better position to educate the public through various marketing channels. With a larger marketing budget, a dental network can reach out to consumers in a way that single clinics can't. And they can often communicate with consumers in a more compelling way. Dental chains can also introduce the latest dental advancements without having to charge exorbitant fees.
The emergence of branded dental networks is a welcome development in a country that is much in need of improved dental health. As the trend continues, expect to see more Indians "Smile for Life" on World Oral Health Day and throughout the year.