JOHCD

Arun R Nair et al 10.5005/jp-journals-10062-0008

REVIEW ARTICLE

Dental Education: Challenges and Changes

1
Arun R Nair, 2GM Prashant, 3PG Naveen Kumar, 4V Hirekalmath Sushanth, 5Mohamed Imranulla, 6Priyanka P Madhu

ABSTRACT Poor oral health and untreated dental conditions can

have a significant impact on the quality of life leading
The aim of dental health education is to impart knowledge on
the causes of oral diseases and providing the ways and pos-
to overall deterioration of health.1 Dental education has
sibilities of their prevention and adequate treatment. Health arrived at a crossroads. During the last 150 years, it has
education would highlight the necessity of proper nutrition, evolved from a prelude to apprenticeship into a compre-
maintenance of oral hygiene with the use of fluoride prod- hensive program of professional education.2 As there is
ucts, and other regimen as well as drive attention toward the advancement in science, technology, and public health
significance of regular check-ups with a dentist. Public health
programs, there have been great reduction in tooth decay
dentistry in India has become the only key toward future dental
workforce and strategies. There have been numerous chal- and tooth loss. Due to these reasons, dentists are treated as
lenges which exist for expanding oral health care in India, in respected professionals, and dental schools are part of many
which the biggest challenge is the need for dental health plan- of the nation’s leading public and private universities.2
ners with relevant qualifications and training in public health Henceforth, the future of dental education will be
dentistry. There is a serious lack of authentic and valid data
shaped, in part, by scientific, technological, political, and
for assessment of community demands, as well as the lack of
an organized system for monitoring oral health care services economic factors that are largely beyond the profession’s
to guide planners. Based on the aim for sustained develop- control.2
ment, human resource planning and utilization should be used
along with a system of monitoring and evaluation. Hence, both ORAL HEALTH EDUCATION AND
demand and supply influence the ability of the dental workforce HEALTH PROMOTION
to adequately and efficiently provide dental care to an Indian
population which is growing in size and diversity. The World Health Organization (WHO) states that “the
Keywords: Challenges, Changing concepts, Dental educa- extension to all people of the benefits of medical, psycho-
tion, Future dental workforce, Promotion of oral health. logical and related knowledge is essential to the fullest
attainment of health.”
How to cite this article: Nair AR, Prashant GM, Kumar PGN,
The Dental Council of India (DCI) is a statutory body
Sushanth VH, Imranulla M, Madhu PP. Dental Education: Chal-
lenges and Changes. J Oral Health Comm Dent 2017;11(2):34-37.
which was constituted by an Act of Parliament through
the Dentists Act (1948). The main objectives of DCI are to
Source of support: Nil
promote dental education, dental profession, and ethics
Conflict of interest: None in India and to start new dental colleges or higher courses
and increase the number of seats which can be done
INTRODUCTION AND BACKGROUND through recommendations to the Government of India.3-5
The WHO defines health promotion as being a
Dental diseases are among the most common and wide- “process of enabling people to increase control over,
spread diseases around the globe.1 There is an old saying and to improve, their health. It moves beyond a focus
about the eyes being windows to the soul. But the latest on individual behavior towards a wide range of social
medical and dental research shows that the mouth truly and environmental interventions.”3,6 Creation of healthy
is a window into one’s overall health. Not only does the public policies and environments, development of per-
mouth tattle on the rest of the body, oral health can actu- sonal skills, and reorientation of the oral health services
ally affect overall health. are various criteria which help in promotion of oral
health. This last definition is different from oral health
1,6
Postgraduate Student, 2Professor, 3Professor and Head
education as it is mostly aimed at improving oral health
4,5
Reader through the steps of acquisition of knowledge, eventually
1-6
Department of Public Health Dentistry, College of Dental leading to motivation and, finally to behavioral changes
Sciences, Davangere, Karnataka, India according to the health belief model.3,7,8 The remarkable
Corresponding Author: Arun R Nair, Postgraduate Student improvements in oral health in the last years reflect the
Department of Public Health Dentistry, College of Dental strong scientific basis for prevention of oral diseases that
Sciences, Davangere, Karnataka, India, Phone: +918867164242 have been developed and applied in the community, in
e-mail: arunblasts@gmail.com
clinical practice, and at home.3,5,9

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 JOHCD

Dental Education: Challenges and Changes

CHALLENGES Pradhan Mantri Gram Sadak Yojana Scheme is looking to

eliminate the barriers of transportation to remote villages.4
Majority of the programs failed to achieve their aims
School dental health education programs have pro-
due to the lack of attention mostly resulting from the
duced positive results which are evident from different
inadequate and insufficient relationship patient–health
studies. Different studies have different impacts and this
professional in its educational aspect.3,10 Various studies
may be attributed to different study populations and dif-
demonstrate that socioeconomic and cultural aspects
ferent methods of dental health education presentation
may influence the oral hygiene habits. The higher risk of
and other environmental factors, such as barriers of com-
oral diseases and lower socioeconomic status were well
munication, efficiency of educators, etc. This could have
explained by the lack of information and knowledge
a modifying effect on the effectiveness of the educational
about oral health behaviors and limited access to dental
intervention.1
health care.3,11-15 The degree of association between a
Policy Developments: The principle of “The National
number of social, economic, and behavioral risk factors
Oral Health Policy” was accepted by the Ministry of
and the prevalence data for adverse oral conditions have
Health and Family Welfare, Government of India, in the
been determined in various studies. These associations
year 1995 with plan of extending minimum oral health
should be interpreted with caution as they suggest the
to the entire Indian population.
need to take them into consideration when developing
Financing and Reimbursement: Oral health care
health-promoting oral health policies.3,16-18
systems exist in societies with different social and eco-
Various studies have confirmed that low social class
nomic systems that influence the structure and process
had increased the risk of developing high levels of dental
of care.
caries.3,19 Parent’s low educational level and professional
Direct payment from private services is the main
situation (employed/unemployed) also played an impor-
payment mechanism in India. Financing and reimburse-
tant role in the child/adolescent’s oral health status.3,20,21
ment system influence the other parts of oral health care
Oral health education is an important issue that should be
system. In the strategic planning for financing dental
developed among the population with a view to decreas-
organization the growing awareness of oral health as a
ing the prevalence of oral illnesses.3,22
part of general health has been reflected highly. Evidence
“Patient access to a selected panel of dentists” such
suggests that dental insurance, number of dentists, and
Health plans are moving beyond their historically small
increasing the number of people with teeth and income
base. However, because more than half the population is
have positive impacts on dental expenditures and when
not insured for dental services compared with less than
there is restriction in any of these conditions, there would
one-fifth with no health insurance, the impact of health
be a reduction in dental expenditures.
care restructuring has, so far, been relatively limited for
Indian Scenario for Dental Finance (Ministry of Health
many practitioners and patients. Even though only about
and Family Welfare: Government of India, 2005), Stand Alone
6% of all expenditures for personal health services are
Dental Insurance Plan: Dental problems, such as periodon-
accounted for by dental services, majority of this expense is
titis and extraction of permanent teeth due to ailments,
not covered by insurance.2 Dental education faces serious
such as caries, cover the expenses needed for this. Amount
financial problems that, in many respects, constrain its
to be reimbursed for the expense as well as the period of
ability to respond to the changes identified above.
such cover is fixed beforehand. The type of oral health care
delivery system that suits our country is the next issue of
CHANGING CONCEPTS concern as far as the implementation of the policy. Out
Scientific and technological advances are reinforcing the of four well-known models of oral health care delivery
medical aspects of dental practice, as new or improved systems currently existing in the world, there is a strong
preventive, diagnostic, and pharmacological interven- recommendation for adoption of Beveridge model for
tions challenge procedure-oriented dental education.2 developing countries like India. In Beveridge model, the
Currently, there are 301 dental colleges offering den- government is responsible for providing and financing
tistry in India and on an average approximately 25,000 of oral health care for its countrymen and funding for
graduate students and 4,500 postgraduate students are dental care is achieved through the taxes collected by the
passing out every year from various dental colleges in the government, which is currently adopted in UK.4
country. This is a positive indication for the availability of
RECOMMENDATIONS
the dental workforce.4 Mobile dental units are made avail-
able to the primary health centers (PHCs) so as to provide The governments (central and state) should provide
dental services at remote and hilly areas of the country as dental services to those people who are below the poverty
Journal of Oral Health and Community Dentistry, May-August 2017;11(2):34-37 35
Arun R Nair et al

line on priority basis. A separate budget by both the REFERENCES

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Journal of Oral Health and Community Dentistry, May-August 2017;11(2):34-37 37