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The Changing Environment of Oral Healthcare and the Need for Innovative Solutions

(Hony) Brig Dr Anil Kohli

President, Dental Council of India

“No man ever steps in the same river twice, for it's not the same river and he's not the same man.” This quote from Heraclitus illustrates the rapidly shifting world that is the art, science, and community of oral healthcare. This month, the Perspective from the Dental Council of India (DCI) focuses on the many challenges in the swiftly-moving healthcare environment, how these issues change, and how our approaches must continue to adjust. Our country—and the global community—is witnessing unprecedented changes in economic, social, technological, scientific, and political arenas. We are realizing that these issues are truly interconnected, that responses in one area may have unintended consequences in another. Thus there is a need for innovative solutions that encompass a variety of situations.

One such challenge is the distribution of dental service providers throughout India, and the access-to-care imbalance between urban and rural areas. Although there has been an increase in the number of dental colleges, these have been concentrated in urban areas. This situation calls for a multi-pronged strategy to alter the circumstances. One possible approach would be to increase government spending on healthcare and establish dental departments at primary health centers in rural areas. A corresponding tactic would be to restrict the number of private dental colleges in the country. The DCI has requested to have a dentist located at every primary health center in the country, and to limit the development of more colleges because of the shortage of teaching faculty.

In addition, organizations such as the DCI must obtain and analyze the current demographic trends on patient populations and their access to care. The DCI gave a presentation to a planning commission on a project to conduct a survey on manpower for planning purposes. The Council recognizes the need for national surveys on the location and availability of dental practitioners: armed with this knowledge, we may take steps to help adjust the mal-distribution of dental manpower. Even minor changes set in motion today may result in substantial benefits in the future. These changes must take place through coordinated efforts by influential people and organizations, with a shared goal.

However, the education and distribution of dental practitioners is only part of the challenges we face. We must also focus on the need for preventive services and for dental healthcare education programs for the population. There are numerous ways to design and implement these programs, and many venues through which to provide these services. Whatever our actions, there is a need to monitor, evaluate, and adjust these programs to make the best use of our resources. In this environment, programs that were successful in the past may no longer be effective. The ways that people receive and process information have changed dramatically, offering us new opportunities to deliver the message of oral health.

Recently, our country has experienced a national election, one which will most likely result in new healthcare proposals and changes to previous ones. The new government plans to increase healthcare spending from 0.9% to 3% of the GDP (whereas in developed countries, the average is over 6%). In addition, the unprecedented global economic situation challenges our usual responses and calls for creative thinking. The DCI is looking forward to many opportunities to help plan and implement innovative oral healthcare programs.

Oral diseases are a serious burden to our entire population, causing significant economic and social problems in addition to the damage to individual health. We cannot afford to wait, sit back, and rely upon old plans and visions to take effect. We must actively engage, over and over, in this changing environment. The DCI is committed to its responsibility to remain in the forefront of oral healthcare issues.