The tooth, the whole tooth and nothing but the tooth!

Updated on: Sunday, July 11, 2010

“Education is a better safeguard of liberty than a standing army,” said Edward Everet.

Fresh dental graduates prefer joining call centres as staff! A majority lack the confidence to start private practice right after the completion of postgraduation attained by hardly attending classes! By all outward signs, the dental profession is prospering. However, signs of a looming crisis in dental education threaten the future effectiveness of the profession. Hope it is not moving into a phase of extinction from extraction!

The Dental Council of India (DCI) is a statutory body incorporated under an Act of Parliament: The Dentists Act, 1948 (XVI of 1948). Set up to regulate dental education, the DCI has failed to handle the challenges on many fronts.

The regulator claims authority but does not hold itself responsible or accountable for the debacle. It keeps complaining about mushrooming of colleges and shrinking of jobs; yet, it gives approval for more fresh colleges.

Does this mean that the regulator was ignorant of the level of saturation and the distribution of the 183 colleges in 2004? I quote the DCI president, who recently said: “There is no equal distribution of dental colleges. Take, for example, Australia with a two crore population. It has five dental schools. On the other hand, Kerala with a 2.5-crore population alone has 23 dental colleges, and still 6,000 posts of dentists in the Union Government are lying vacant.” Who accorded approval for these colleges knowing very well it was one too many? If any objection was made, how come it fell on deaf ears? Why has the proposal to start 100-plus institutions since 2004 been approved? Who is accountable, responsible and answerable for the lapses in oral health care delivery systems?

Talking of dental education, one should admit that the emphasis on learning by rote has resulted in reduced skill in students of dental sciences, which are predominantly about dexterity and skilled clinical training. There is need for a drastic change in approach, and unless we bring about a complete paradigm shift, we may find ourselves falling behind in this 21st century of unlimited opportunities.

The severe shortage of teaching faculty, coupled with the proliferation of colleges (capitation-based, community-based, deemed university status), ensured that the primary focus was on hiring teachers. A few members of the faculty have capitalised on this serious lacuna in the demand-supply chain and showed up only for inspections.

Regulators should have ensured practical solutions to tide over the problem. They have just made it worse by introducing the countrywide biometric real-time attendance! It's almost like compulsive tail-chasing for approximately 12,000 dental surgeons, 10,000 medical teachers as well as 10,000 auxiliary personnel.

Can such a colossal task of real-time be monitored from just one base at the centre? Is it truly a viable option? Many stakeholders are already innovating methods to beat this system, which ensures only the physical presence of a teacher but does not address the issue of imparting quality (proxy biometric fingerprinting). Wonder why some government colleges are exempted from the biometric attendance?

Why not legalise part-time teaching rather than police people and force them to commit crimes and bend and break rules? It is a widely accepted norm in reputed institutions all over the world to include a good mix of full-time and visiting faculty. Legalisation of the visiting faculty enables the sharing of knowledge and improved clinical training which is so crucial in dentistry.

Some colleges are geographically located in areas where a serious dearth of patients is recorded. Attempts are rarely made to impart hands-on training, especially in dentistry, which so heavily relies on clinics and experience. Out-patient records are mostly fudged to meet the so-called “required minimum” numbers. The current guideline/ordinance, though improvised, is actually much more stifling and rigid.

At the moment, India has one dentist for 10,000 persons in urban areas and about 2.5 lakh persons in rural areas. Almost three-fourths of the total number of dentists are clustered in urban areas, which house only one-fourth of the country's population. Almost 80 per cent of the focus is currently on urban areas. Systems ordained must be easy to comprehend, easy to implement, and most transparent to maintain.

The focus must be on participation and equity, and not autocracy. The helplessness of the regulator to execute its responsibility is surely a sign of a serious handicap. There is no point in having a regulator if it cannot perform or constantly expresses its inability to do what it is supposed to do — regulate!

The DCI must be held accountable, responsible and answerable. The DCI president recently said: “There is a serious dearth of visiting faculty. It has become a lucrative business to start a new dental college. This clearly explains a sudden increase in the number of dental colleges applying for permission to the DCI.” Answers are well within these statements.

It is indeed time to debate the scarcity of resources, severe shortage of teaching faculty, inequity in distribution of institutions and absolute inefficiency in utilisation in rural as well as urban areas and invent methods of overcoming them.

The tooth, the whole tooth and nothing but the tooth!

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