Dr Raja Muzaffar Bhat
Dentistry is no more about extraction of a tooth or filling the dental cavities. This is now a multifaceted science that includes the ability to speak, smile, smell, taste, touch, chew, swallow. Dental and oral health helps to convey a range of emotions through facial expressions with confidence and without pain. Modern dentistry is a science of practice and research directed to facilitating healthy development of dentition, jaws and dento- facial structures. It is related to prevention of not only dental diseases but all the oral diseases plus promotion of better oral health. Dentistry now-a-days involves various diagnostic tests, investigations and procedures to decide the normal and abnormal state of oral health especially related to teeth, gums, jaws and the surrounding tissues. There are lots of specialized procedures in dental science that help not only in prevention of dental diseases but also adds to facial looks of a person.
With the callous attitude of all the previous Governments in Jammu and Kashmir towards dentistry and not having a clear policy or vision for taking modern dental science to poor and disadvantaged communities in J&K , it is hoped that the present Government headed by Lt Governor Manoj Sinha needs to view this issue seriously. Government of Jammu and Kashmir could have utilized services of hundreds of qualified dental graduates (BDS) and post graduates (MDS) in addressing dental health problems, but that hasn’t been done in spite of the fact that a huge national flagship programme , the National Health Mission (NHM) earlier called NRHM is still in operation for last more than 15 years. The indifferent attitude of the Govt has now forced these qualified people to come to the streets.
As per the norms set by World Health Organization (WHO) there has to be one qualified dentist for 7500 population. In Jammu and Kashmir we have one qualified dentist for a population of 28000 people. When this author raised the same issue with Muzaffar Hussain Baig in 2004 while he was Finance Minister of J&K, Mr Baigh told me that ” Kashmir America nahi hai”. This is the attitude of our politicians and officials at the helm towards dentistry. During that time, I along with a group of fresh dental graduates were fighting for creation of 350 posts of dental surgeons which in fact became a reality after our sustained struggle for 2-3 years. Prof (Dr) H U Malik, President Indian Dental Association (IDA) J&K state branch who is much passionate about dentistry and dental fraternity was a great guide and support for us during those days as well. We used to have constant meetings with him in his clinic at Jahangir Chowk Srinagar. Dental surgeons across J&K cherish his activism and enthusiasm for the community.
Unfortunately, due to the huge bungling done by members of the Public Service Commission (PSC) during the selection process, many bright dentists could not get the Govt job that time, but they do better in their private practice. The Government has to have more than 1700 qualified dentists in J&K to cater to the needs of 1.30 crore population but as of now there are only 543 such posts available with the Government in its various health institutions. The Govt of J&K can easily accommodate 1000 qualified dentists to meet the requirements as mandated by WHO.
NRHM, NHM and Oro-Dental health
The National Rural Health Mission (NRHM) was launched on April 12th 2005 which was named as National Health Mission (NHM) in 2012 was not helpful to counter Oral dental diseases. The Government brought Unani , Ayurvedic and other Indian System of Medicine under these flagship programmes but the qualified dental graduates or ancillary staff (dental hygienists , dental technicians , dental mechanics) were not at all given any preference. Unfortunately many ISM doctors hardly practice unani or ayurvedic medical science and instead prescribe allopathic medicines to patients. This is never being noticed. On the other hand the qualified dental surgeons who could have given their best service to people in far off places were left to God’s mercy. They were not deemed fit for an NRHM job by Govt. The access to dental services has not improved much in the last 20 years as it should have. The provisions for improving oral and dental health services have mostly been utilized in a limited way by some states only leading to overall lack of assured oral health care services both in rural and urban areas.
Various studies have clearly identified that the gap in perceiving the problems due to various oral health conditions by the population exist largely because of lack of awareness. This shows the lack of demand for oral health services in the population. There are gaps in demand and supply. The Government of India is coming out with this Oral Health Policy for improving the entire spectrum of oral health from planning to implementation. National Oral Health Policy has therefore been brought out enhancing an enabling environment to all the professionals and institutes who are contributing positively in rendering good quality oral health care for the public. The policy clearly indicates the positive intent of the Government in improving and uplifting oral health care services with cost effective and wider access for all particularly those priority populations. It is hoped that under the ambit of the policy, states will be able to leverage the benefit in planning and implementation of various oral health care programs. These efforts will lead to improve the oral health indicators among the population of the country.
National Oral Health
Due to high prevalence of oral-dental disease in India , the oro-dental diseases are a public health problem which have tremendous impact on the systemic health. Poor oral health leads to poor aesthetics, affects mastication adversely, causes agonizing pain and can lead to loss of productivity due to loss of man-hours.
The National Oral Health Programme (NOHP) was launched during 2014 – 15 to strengthen the public health facilities of the country for an accessible, affordable and quality oral health care delivery.
Creation of posts
In the past the Health and Medical Education Department had sent some proposals to the Finance Department for filling up vacant posts of Dental Surgeons. It has been rejected in view of huge financial implications which indicates dentistry is not a priority health issue for the Government. This is frustrating around 7000 qualified dentists in J&K, many of whom have been protesting against the Govt for the last some weeks in Jammu under the banner of Dental Surgeons Association J&K. These protesting dentists demand that Govt must create fresh posts of dental surgeons in J&K and also adjust them under various Govt schemes like National Health Mission (NHM) etc. While talking to the media recently president of Dental Surgeons Association J&K Dr Javid Iqbal Chowdhary said that their agitation will continue as Govt has not created any posts for them for the last many years.
It is ironic that in the last 13 years not even a single dental surgeon has been appointed by J&K Public Service Commission (PSC). If new posts are created for Unani , Ayurvedic doctors or Veterinary doctors why not create posts of dental surgeons ? Majority of medical doctors are absorbed in Govt after they complete their medical degree but in case of BDS graduates not even 20 % of them make it to Govt departments. This is sheer injustice. For starting a private dental clinic, a lot of investment is needed. It is difficult for many dental graduates to start private practice. In 2019 a proposal for creation of 273 posts of dental surgeons was sent to Govt by Director health services Jammu but that too was not given financial concurrence.
I appeal to Additional Chief Secretary Atal Dulloo who is also the administrative secretary health and medical education, to look into the issue with a human heart. At least 500 to 600 new posts of dental surgeons must be created soon. In addition to it a policy be adopted for other unemployed dental surgeons, dental technicians and dental hygienists etc. Govt can utilize their services under public private partnership (PPP) also, which needs to be explored.