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Wednesday, July 17, 2024

The dentistry conundrum in Pakistan

Fresh dentists who enter the workforce after years of rigorous study, hands-on training, and spending significant sums of money on clinical instruments and equipment realize that the promising bright future was nothing more than a scam and that their chances of success are now bleak.

There are multiple anecdotes narrating how becoming a dentist is a shortcut to tapping into unrestricted wealth. Every year, hundreds and thousands of students enroll in dental schools across Pakistan, some with a passion for reforming the oral health care sector while others with aspirations of lucrative economic opportunities. New grads should ideally come across various viable chances in a place like Pakistan, where there aren’t many dentists due to the low population to dentist ratio. But because there are so few options, the hope of finding rewarding opportunities is met with utter disillusionment.

Fresh dentists who enter the workforce after years of rigorous study, hands-on training, and spending significant sums of money on clinical instruments and equipment realize that the promising bright future was nothing more than a scam and that their chances of success are now bleak.

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Understanding the matter better

Even though this results in a significant brain drain, many dentists who cannot afford to leave the nation for better job possibilities are compelled to work for years without any hope of financial reward. Even those who work for pay are paid significantly less than the stipulated minimum salary. A shortage of dentists is also attributed to the growing trend of doctor brides, who are constrained from continuing their careers after marriage and are required to take care of household responsibilities.

Poor government policies, particularly concerning the expansion of dental healthcare services, can be held primarily responsible for the scarcity of resources. In underdeveloped countries, the WHO advises a dentist to population ratio of 1:75,000. The total number of dentists in the nation should, ideally, exceed the suggested ratio, given the number of recent and seasoned graduates. With a dentist to population ratio of 1:1,305,811, Pakistan, regrettably, falls far behind. Compared to metropolitan areas, rural areas have far worse access to dentists and dental care.

Every year, a substantial increase in the unemployment rate is caused by the hundreds of thousands of new dentists entering the market. For a sizable portion of the population in Pakistan, access to primary healthcare is a utopian dream, and access to oral and dental healthcare is even more limited. Dental issues are not even classified as medical issues; they are given the lowest priority tier.

Yet, several dental issues have the potential to be fatal.

The prevalence of quacks predominating in private dental clinics is another significant factor contributing to the shortage of chances for qualified dentists. As unexpected as it may sound, there are more dental clinics managed by charlatans than by licensed dentists. The lack of awareness among the masses regarding quackery is further incentivized by the affordable dental care offered by a quack.

For short-term economic benefits, a significant section of the population severely jeopardizes its health by opting for quack-owned practices. In addition to lacking the necessary skills for effective treatment, quacks also raise the overall disease burden through poor infection control procedures, which are the primary source of blood-borne viral diseases like Hepatitis B, C, and HIV.

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The Pakistan Dental Association has often warned about the apparent rise in public health burden brought on by the perilous situation with access to dentistry. If remedial action is not taken to mitigate the effects, it has even been stated that there is a risk that the lethal oral diseases would spread and become epidemic.

The unfortunate situation regarding the lack of employment possibilities for dentists and the gap in access to dental care for the general populace in Pakistan has been acknowledged by succeeding governments. However, little is being done on the policy front, and there is a severe lack of concrete measures.

Although it is a lesser-known phenomenon, there is a connection between systemic disorders and dentistry. Preventing oral problems is associated with the early detection and prevention of several systemic diseases. Unfortunately, neither the general public nor the decision-makers know its significance.

Currently, mouth cancer is typically only discovered after it is already too late to be cured, rendering it lethal. As the second most prevalent cancer in Pakistan and one of the top ten malignancies worldwide, oral cancer can be promptly detected, treated, and avoided with regular dental checkups. Presently, mouth cancers are usually detected in the last stage, which is beyond the curable stage and thus proves fatal.

The way forward

It is imperative to have a public health framework that emphasizes oral and dental health. The government should invest in expanding the opportunities available to dentists in public hospitals and primary healthcare facilities. Along with the lack of opportunity, pervasive nepotism endangers the future of qualified dentists. As a result, only merit should be considered when deciding who gets inducted. There should also be a crackdown on quack-owned dental practices to eliminate these menaces from society.

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To address the growing brain drain and shortage of practicing dentists, the government should enact policies requiring newly graduated dentists to serve a minimum number of years.

The Pakistani government must immediately outlaw chewable tobacco products like areca nut and betel nut, more commonly known as gutka and chalia, to expand possibilities for dentists and close access gaps. Additionally, there aren’t enough public health initiatives like free annual dental exams and water fluoridation. Most dental conditions can be easily controlled by establishing public health programs at the policymaking level.

The collaborative efforts of the government and the private sector can help control the growing burden of dental ailments on the country’s overall disease burden. Additionally, it can help revive dentistry’s status as a rewarding profession.


The writer is a dentist by profession. The views expressed in this article are the author’s own and do not necessarily reflect the editorial policy of Global Village Space.