Smile, please

When Padmini, 21, walked into Dr Gaganpreet Kapoor’s clinic in Delhi along with her mother, she was afraid to smile because she had wide gaps between her (also discoloured) teeth.

Suffering from fluorosis, a disease caused by excess fluoride levels in water, common in some parts of Rajasthan, her home state, Padmini was given porcelain laminates to cover the gaps and take care of the discolouration. Today, this young lady can flash a brilliant smile without a care in the world.

Welcome to the world of dentistry. “Aesthetic dentistry, popular in the West, is all about ‘smile designing’, enhancing people’s looks by improving upon the colour and shape of their teeth and the shape of their gums,” says Dr Kapoor, consultant dental surgeon and cosmetic dentist, BLK Memorial Hospital, New Delhi.

Kapoor, who had always wanted to be a doctor, says her independent spirit prompted her to choose dentistry. “You can practise independently — dentists start their own clinics much quicker than those in other branches of medicine,” she says. In 2004, after graduation, Kapoor joined a TPA (third-party administrator) in the insurance sector as a medical officer. But as her heart was in treating patients, she took up dental practice.

Apart from aesthetic or cosmetic dentistry there are other specialities, too.

Prosthodontics deals with the replacement of missing or damaged teeth; periodontics deals with diseases of tooth-supporting tissues and the gum tissue; pedodontics is related to dental problems of children.

With increasing awareness of oral health needs, the demand for good dentists is also increasing, says Dr Sanghamitra Yadav, chairperson, community dental health (CDH), Indian Dental Association (IDA), north Delhi branch.

As with most medical disciplines, the concentration of dentists is skewed in favour of urban areas, says Dr Debipada Kabi, head of the department, dental surgery, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi. “The infrastructure in the cities is adequate but those in the rural areas need improvement. Moreover, there is lack of awareness about oral health and its importance in the rural areas,” he says.

Retired Major General (Dr) PN Awasthi, secretary, Dental Council of India, agrees.

“There are 88,000 registered dentists in India. But there is no mechanism to correlate the demand and supply ratio. As a result, there is concentration (of dentists) in the urban areas and lack of doctors in rural areas,” he points out.

The world definitely needs to wake up to the fact that oral health is directly related to the general health of a person. “It is established that pregnant women suffering from gum diseases have more chances of delivering pre-term babies with low birth weight,” says Dr Kabi.

Cardiac diseases, hypertension, diabetes, respiratory problems etc are affected by oral health as well. “Patients suffering from systemic diseases should be provided good oral health treatment to bring down morbidity and mortality rates,” says Dr Kabi.

What quality of dental care do we get in India? “Techno- logically and methodologi- cally, we are at par with the best in the world,” says Dr Vishal Gupta, consultant orthodontist and implanto- logist. Dr Kabi, however, disagrees, saying some catching up needs to be done before India can rival the best in the world. “In developed nations, only a prosthodontist is allowed to offer crown and bridge treatment. In India, even a general dentist can do it,” he says.

Also, the quality of education that one gets in most private dental colleges is poor, says Dr Kabi. Dr Awasthi agrees: “What is required is monitoring of the existing dental colleges.” The ministry of health, the Planning Commission and the state governments should also monitor the standards of new colleges, to ensure quality output, he says.

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What's it about?
Dentistry is the science of diagnoses, prevention and treatment of diseases related to the teeth, jaws and soft tissues of the mouth. Treatment includes restorative dentistry, which focuses on correcting problems of the teeth caused mainly by dental decay (cavity), and fixing the position of the teeth in relation to each other and to the jawbones. Dentists also treat injuries, infections, tumours and other conditions of the teeth, jawbones and related tissues. Aesthetic or cosmetic dentistry offers restorative treatments simply to improve a patient’s appearance

Clock Work
This is the work schedule of a doctor in a public or private hospital. The work day of a consultant or someone in private practice is different.
9 am: Reach hospital
10 am: Carry out routine clinical treatments and see patients in

OPD
Noon: Do administrative/ clinical work
1 pm: Lunch
1.30 pm: Treat patients who have appointments
4.30 pm: Meet staff/officials
6 pm: Call it a day

The Payoff
In the government sector, the average packages are
Rs 50,000 per month (entry level), Rs 75,000 to Rs 1 lakh per month (middle level) and Rs 1.5 lakh per month (senior level). In the private sector, the pay varies according to experience and expertise. A doctor with a good private practice can bring home handsome earnings

Skills
. Creativity and an innate interest in health sciences
. Steady hands
. Aptitude for learning new skills as dental procedures change all the time
. Ability to work tirelessly

How do i get there?
Take physics, chemistry and biology at the Plus Two level and then clear the pre-medical entrance examination of states/boards/institutions. After the five-year Bachelor of Dental Surgery (BDS) course, you can go in for a postgraduate degree.

There are several specialisations to choose from. The Indian Dental Association organises various continuing dental education (CDE) programmes where one can update one’s knowledge of modern dentistry

Institutes & urls
. Maulana Azad Institute of Dental Sciences, New Delhi
www.madch.ac.in
. KGMC, Lucknow
www.kgmcindia.edu
. R Ahmed Dental College, Kolkata
. Government Dental College, Mumbai
. Dental College, Dharwad, Karnataka
. College of Dental Sciences, Manipal
www.manipal.edu
. GDC, Trivandrum
www.gdctvm.org

Pros & Cons
. No late nights
. You can transform a person’s life by changing his/her appearance
. One might have to sit for long hours and suffer from back pain as a result
. No correlation between academic performance and earnings

The future is excellent

A senior practitioner talks about the highs and lows of the profession

Does India have enough good dentists?
Yes and no. There are plenty of dentists in urban areas, and not many in the rural areas.

The reason is that professionals do not want to go to rural areas. I request the government to appoint dental surgeons in primary health centres in rural areas and involve the National Rural Health Mission in promoting oral health.

Does our oral healthcare quality match world standards?
No, because there is no awareness at the ground level about dental diseases and the importance of oral hygiene. It is very important to tell school children about dental diseases so that problems can be detected at an early age. There is a need for awareness programmes organised by dental associations and the media — both print and electronic.

How important is the role of a dentist in our medical set-up?
Very important. With changing lifestyles, many diseases, like cardiac problems or diabetes, are directly or indirectly related to oral conditions. Eating habits have changed, and the fast food culture is adding to dental problems.

What is the single biggest challenge for the profession?
Generating employment for young graduates is the most important challenge.

How has treatment changed over the years?
Newer techniques have come into existence, such as cosmetic dentistry, implant dentistry, laser dentistry, etc. The need and importance of oral care has increased
manifold.

What is the future of dentistry as a profession in the country?
The future is excellent. If you are sincere and honest with the profession, you can make a good living out of it, but you will have to work hard.

Dr Anil Kohli, president, Dental Council of India Interviewed by Pranab Ghosh