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Feature

DCI Perspective

Sep 2007 — Vol. 1, Iss. 1

Status of Dental Education in India

Dental education today must ensure that professionals are equipped to deal with the challenges of tomorrow, and in an increasingly globalized scenario, how we educate our future professionals will decide the future of our country.  

The Dental Council of India (DCI) is a Statutory Body in India incorporated under an Act of Parliament viz The Dentists Act, 1948 (XVI of 1948) to regulate the dental education and the profession of dentistry throughout the country. The general body of the Dental Council of India represents various state governments, universities, dental colleges, central government, etc.

The Council has to meet the challenges in a diverse system of culture and geography to empower dental surgeons to render quality service on par with international standards. Coursework and professional training in India pose a number of challenges requiring a review of educational priorities and expectations. My thoughts are aired as an approach to planning for the future. This decade is critical for dental education to ensure a correct mix of traditionally accepted information; the latest information and techniques that must be incorporated into any program that focuses on the needs of a modern, preventive-oriented, minimal-intervention type of clinical practice. The dilemma is compounded by a wealth of new information that includes restorative materials, implants, acute and chronic orofacial pain, general medicine, oral medicine and pathology, management of immunosuppressed patients, surgical cure of diseases and disorders, prosthodontic rehabilitation ensuring optimum esthetics and function, and gerodontics. There is the question of resources and facilities for the prioritizing of educational needs.

In a country like India, the demands of faculty and facilitation are tremendous challenges, and as such, the supply most often cannot cater to the needs of the same. The need of the hour is to have institutions that have standardized basic and advanced training curriculum to ensure trained young minds are being inducted in the field of practice of dental sciences, both basic and specialist. Before dental college or a postgraduate dental department is set up, it should essentially fulfill certain minimum requirements in respect to the staff, equipment, buildings, etc, without which it is next to impossible to ensure that the students joining these institutions will be able to attain the dental education of the prescribed standards in a standardized format. With a view to maintain high standards of academics, it is imperative that the concerned authorities and the universities ensure that no dental college is permitted to start functioning unless and until the Dental Council has satisfied itself, through inspection or otherwise, that the teaching staff, equipment, buildings, etc, are in conformity with the minimum requirements as laid down by the Council and approved by the central government; and, similarly, that no dental institution is permitted to start postgraduate course(s) unless and until the Council has satisfied itself, through inspection or otherwise, that the minimum requirements in respect to teaching staff, equipment, etc, have been fully provided for in respect to BDS courses and that the teaching staff, equipment, etc, for the postgraduate course(s) are in conformity with the minimum requirements laid down by the Dental Council of India and approved by the central government.

The objective is to train a candidate so as to ensure higher competence in both general and specialized areas of interest and prepare for a career in teaching, research, or specialty practice. A can-didate must achieve a high degree of clinical proficiency in the subject matter and develop a competence in research and its methodology as related to the fields concerned. Hence, novel ideas have been introduced to cater to this burning need of the hour, such as scientific training during the undergraduate and postgraduate courses, starting DNB programs, fellowship programs, etc, which might ease the tipping scales in favor of quality dental education on par with global standards.

Dentistry in India faces serious problems regarding accessibility of its services to all. In a developing country like India, oral healthcare services are most often offered by dentists who practice in the cities and treat the affluent parts of the urban population. It is often difficult for the poor urban and the rural population to get access to oral healthcare. Community-oriented oral health programs are seldom found. The major missing link causing this unfortunate situation is the absence of a primary healthcare approach in dentistry.

To tackle this problem, we have planned for the re-orientation of the dentists working in urban areas and implementation of a primary prevention package through the school health schemes in the different urban areas. The dental institutions have been encouraged to adopt the adjoining villages and the slum areas and provide them with community-based oral healthcare programs. In addition, these institutions are also providing the dependent population treatment for free or at negligible cost. This way, a large number of villages have been covered by the dental institutions because of the involvement of the Council. In India, with an increasing level of dental diseases compounded with limited resources and manpower, it seems practically impossible to provide interceptive and curative services to each and every individual. The most viable means to handle such situations is to follow the preventive approach. This is relatively simple and cost-effective, and uses oral health education, preventive strategies, and mass media.

It is well-established that preventive programs are most cost-effective and beneficial. However, these are largely lacking in India, and a mostly restorative and rehabilitative approach is being practiced, which is neither affordable nor easily available in all parts of the country. About 75% of the rural population does not have easy access to dental facilities; hence, it is essential for a vast country like India to practice the “preventive approach,” including imparting dental health education and promotion of oral healthcare.

With a large-scale increase in the number of dental colleges over past 10 years, there has been a marked improvement in the dentist-to-population ratio in general terms. There was a similar improvement during the 1980s to 1990s; from 1:80,000 to 1: 42,500. At present the dentist-to-population ratio in India is 1:13,000. However, a significant geographic imbalance among the location of dental colleges in the country results in great variation in the dentist-to-population ratio. The balance is heavily tilted toward the urban areas; the rural areas hardly have any qualified dentists.

Educators faced with limited time for didactic and clinical coursework and declining resources need to have realistic expectations of what can be achieved in an undergraduate program. Our aim is to be primarily educational and secondarily vocational. Primary goals include the development of a knowledge base for problem solving, the fostering of an inquiring mind, and a critical appreciation of new developments. Secondary goals include knowledge of human behavior, and skills in patient management, assessment, diagnosis, and treatment planning. The clinician should be able to manage problems as they arise, cope with new circumstances, and be competent to adapt to future demands.

The highly technical nature of clinical dentistry and the focus on the technical aspects of laboratory procedures necessitates the learning of skills to impart treatment with strong fundamentals. Modern training cannot continue to lay emphasis on the technical aspects of dentistry that were important 50 years ago. With the development of newer materials and advanced techniques, the learning process has to be dynamic, which has to be catered for in the teaching curricula for the students to stay current with the latest in the world.

The future must marry and empower the significant technical capacities of young students with the “soft skills” that include communication, team building, and global knowledge that will be required as an essential part of dental education in India, as it is aimed at increasing the student’s knowledge of the world, its demands, and its people.  This we have made possible by collaboration and dialogue between schools of different countries with a firm belief that “varied cultures develop the nation” further. Steps are being taken to facilitate the exchange of students as well as teaching pedagogy. Our curriculum must include the provision of frequent professional updates and scientific exchange. This has enhanced awareness and implementation of standardized clinical techniques followed the world over.

Continuing education, on the other hand, is an ongoing process that allows clinicians to update their theoretical knowledge and practical skills on a foundation of long-term clinical practice. This is a continuous need and we have overcome the difficulty to ensure that a range of courses are offered at the appropriate academic and clinical levels. The avenues for professional accreditation and reciprocal accreditation are on pace with international standards, as India is surely the hub to future dentistry.

India surely is developing to be the country of “Science & Spirits” and would be the nucleus of all global standards in dentistry. In short, the keyword for the future is Dentistry India.