Setting Dentists’ Teeth on Edge 

Dentists protesting the lack of government jobs in J&K, earlier this year

“KASHMIR America nahi hai” (Kashmir is not America) was the retort that I got from a Former Finance Minister back in 2004, when I had raised the issue of poor Dental Health facilities in J&K. Years after being told off, there has still been no appreciation worthy improvement in this regard.

The callous attitude of all the previous Governments in Jammu & Kashmir towards dentistry has come in the way of making modern dental science reach the poor and disadvantaged communities in J&K.

As per the norms set by World Health Organization (WHO) there has to be one qualified dentist for 7500 population. In Jammu & Kashmir, we have only one qualified dentist for a population of 28000 people as per Indian Dental Association J&K Branch Report.

A majority cannot afford to get dental treatments from private clinics as this is very expensive. Poor and even lower middle class people are forced to go for extraction of teeth rather than having access to a better and advanced root canal treatment (RCT).

The Government has to have more than 1700 qualified dentists in J&K to cater to the needs of 1.30 crore population but as of now there are only 543 such posts available with the Government in its various health institutions. The Govt of J&K can easily accommodate 1000 qualified dentists to meet the requirements as mandated by WHO.

Government of Jammu & Kashmir could have utilized services of hundreds of qualified dental graduates (BDS) and post graduates (MDS) in addressing dental health problems but has failed to do so. This, in spite of the fact that a huge national flagship programme , the National Health Mission (NHM) earlier called NRHM is still in operation for last 15 years or more. The indifferent attitude of the Govt has now forced these qualified people to take to the streets in protest.

NRHM and Dental health

The National Rural Health Mission (NRHM) was launched on April 12th 2005 which was named as National Health Mission (NHM) in 2012 was not helpful to counter oro dental diseases. The Government brought Unani , Ayurvedic and other Indian System of Medicine under these flagship programmes but the qualified dental graduates or ancillary staff (dental hygienists , dental technicians , dental mechanics) were not at all given any preference. Unfortunately, many ISM doctors hardly practice unani or ayurvedic medical science and instead prescribe allopathic medicines to patients. This is never being noticed. On the other hand, qualified dental surgeons who could have given their best service to people in far off places were left to God’s mercy. They were not deemed fit for an NRHM job by Govt. The access to dental services has not improved much in the last 20 years as it should have. The provisions for improving oral and dental health services have mostly been utilized in a limited way by some states only leading to overall lack of assured oral health care services both in rural and urban areas.

Various studies have clearly identified that the gap in perceiving the problems due to various oral health conditions by the population exist largely because of lack of awareness. This shows the lack of demand for oral health services in the population. There are gaps in demand and supply. The Government of India is coming out with this Oral Health Policy for improving the entire spectrum of oral health from planning to implementation. National Oral Health Policy has therefore been brought out enhancing an enabling environment to all the professionals and institutes who are contributing positively in rendering good quality oral health care for the public. The policy clearly indicates the positive intent of the Government in improving and uplifting oral health care services with cost effective and wider access for all particularly those priority populations. It is hoped that under the ambit of the policy, states will be able to leverage the benefit in planning and implementation of various oral health care programs. These efforts will lead to improve the oral health indicators among the population of the country.

National Oral Health Programme

Due to high prevalence of oro-dental disease in India , the oro-dental diseases are a public health problem which have tremendous impact on the systemic health. Poor oral health leads to poor aesthetics, affects mastication adversely, causes agonizing pain and can lead to loss of productivity due to loss of man-hours.

The National Oral Health Programme (NOHP) was launched during 2014 - 15 to strengthen the public health facilities of the country for an accessible, affordable & quality oral health care delivery.

The objectives of this policy are

1.  Improvement in the determinants of oral health e.g. healthy diet, oral hygiene improvement etc and to reduce disparity in oral health accessibility in rural & urban population.

2.  Reduce morbidity from oral diseases by strengthening oral health services at Sub district/district hospital to start with.

3.  Integrate oral health promotion and preventive services with the general health care system and other sectors that influence oral health; namely various National Health Programs.

4.  Promotion of Public Private Partnerships (PPP) for achieving public health goal

Under this programme a support is provided to States and UT’s to set up Dental Care Units at District Hospitals or below. Support is provided for the following components :

o    Manpower support (Dentist, Dental Hygienist, Dental Assistant)

o    Equipment’s including dental Chair

o    Consumables for dental procedures

Massive thrust is given on Information Education and Communication (IEC) programmes by designing IEC materials like Posters, TV, Radio Spots, Training Modules. Organizing national, regional nodal officers training program to enhance the program management skills, review the status of the program

Creation of Fresh Vacancies 

In the past, the Health and Medical Education Department had sent some proposals to the Finance Department for filling up vacant posts of Dental Surgeons. It has been rejected in view of huge financial implications which indicates dentistry is not a priority health issue for the Government. This is coming in the way of around 7000 qualified dentists in J&K. They have held several protests in the past but there was no response from the Govt.

Dental Surgeons Association J&K has been demanding that Govt must create fresh posts of dental surgeons in J&K and also adjust them under various Govt schemes like National Health Mission (NHM) etc. It is ironic that in the last 13 years, not even a single dental surgeon has been appointed by J&K Public Service Commission (PSC). If new vacancies are created for Unani, Ayurvedic doctors or Veterinary doctors why not create posts of dental surgeons?

For starting a private dental clinic, a lot of investment is needed. It is thus difficult for many dental graduates to start private practice.

Majority of medical doctors are absorbed in Government after they complete their medical degree but in case of BDS graduates not even 20 % of them make it to Govt departments. This is sheer injustice.

Views expressed in the article are the author’s own and do not necessarily represent the editorial stance of Kashmir Observer 

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Dr Raja Muzaffar Bhat

Dr Raja Muzaffar Bhat is an Acumen Fellow and Chairman Jammu & Kashmir RTI Movement. Feedback [email protected]

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