Download - Dental manpower
1
Dental Manpower
DR JJ
2CONTENTS
Introduction
Effect of oral health on general health
Levels of health care
Existing health infrastructure
National health expenditure
Oral Disease burden in India
3Dental health services- WHO Classification
Oral health care system in India
Dental work force in India
Dentist
Dental Auxiliaries
4 Role of dental Auxiliary
Challenges to oral health work force in India
Recommendation
Conclusion
Previous year questions
References
5 A dentist, is a surgeon who specializes
in dentistry —the diagnosis, prevention, and
treatment of diseases and conditions of the oral
cavity.
The dentist's supporting team aids in providing
oral health services. The dental team
includes dental assistants, dental
hygienists, dental technicians, and in some
countries, dental therapists.
6
7
8 Oral Disease burden is increasing in the country.
This burden does not only have impact upon
general health but also affect psychology and
economy of the individuals, families and society.
Oral problems are not only causing pain, agony,
functional and esthetic problems but also lead to
loss of working man-hours.
9 Oral health is an integral component of general
health.
Dental Caries and Periodontal problems are
almost universal and are found in many populations
and age groups across the globe and all economies.
India is no exception to these problems and they
are widely prevalent in India too.
The other common oral health problems in India
are Oral Cancer, Fluorosis and Malocclusion.
10 About 60% of school children are suffering from
Dental caries and more than 90% of adults are
having periodontal diseases.
Oral cancer is a life threatening - treatment
modalities - expensive and are way beyond the
reach of the common man.
They can be prevented and controlled - health
education and motivation
11 Thus it is a high time to activate preventive
programmes.
To achieve this, we need to have indulgence of
dental manpower at various levels.
This can be accomplished through the effective
utilization and management of the Dental Health
Care resources…
12
EFFECT OF ORAL HEALTH ON GENERAL HEALTH
13
Oral health and general well-being are inextricably
bound.
Many conditions that plague the body are
manifested in the mouth.
The wide array of habitat renders the mouth-
microbial paradise.
14 Oral infection can have an adverse effect on other
organs of the body.
Broad range of systemic disorders = Diabetes,
AIDS, Sjogren's syndrome, as well as
complications of treatments like Cancer
Chemotherapy and Radiation.
Periodontal disease - Infective Endocarditis
Coronary Artery Disease, Stroke, diabetes etc.
15 Public Health Expenditure
This is very unfortunate that till date in India no serious
effort been taken to improve oral health of the masses.
Till today oral health does not have a separate budget
allocation in national or state health budget.
As compared to other countries, we are still lacking in
paying sufficient attention to such an important part of
our health.
16 In India with increasing level of oral diseases,
limited resources and manpower it seems
practically impossible to provide curative services
to each and every individual, which is primary
duty of Government of India.
To find out a viable mean to handle such situation
the only alternative seems to be
PREVENTIVE APPROACH
17
Social Impact
Oral health is related to well-being and quality of
life as measured along functional, psychosocial,
and economic dimensions.
Diet, nutrition, sleep, psychological status, social
interaction, school, and work are affected by
impaired oral and craniofacial health.
18 ORAL HEALTH CARE SYSTEM IN INDIAOral health care in India is delivered mainly by the following establishments:
1. Government organizations
a. Government Dental Colleges b. Government Medical colleges with dental wing c. District Hospitals with Dental Unit d. Community Health Centers e. Primary Health Centers - Dental units
19 2. Non-governmental a. Private Dental Colleges b. Private Medical Colleges with Dental Wing c. Corporate Hospitals with Dental Units
3. Private practitioners a. Private dental practitioners b. Private dental hospitals c. Private medical hospitals with dental units
20
4. Indigenous systems organizations a. Ayurveda b. Sidda c. Unani d. Homeopathy 5. Voluntary organizations
a. NGOsb. State IDAsc. Colgate palmolived. Rotary clubse. Local authorities, etc.
6. National oral health programmes
21
DENTAL WORKFORCE
22
1. Dentists
2. Dental Auxiliaries
23DENTIST
A dentist is a person licensed to practice
dentistry under the law of the appropriate
state, province, territory or nation.
24 Completion of an approved period of professional
education in an approved institution.
Demonstration of competence
Legally entitled to treat patients
independently, to prescribe certain drugs and
to employ and supervise auxiliary personnel.
Dentists must be both licensed and registered.
25 After being trained for 4 years, followed by one
year of paid CRRI, the student is conferred the
degree of BDS.
The student has to register with DCI through the
state dental council.
he/she can practice dentistry or can pursue PG in a
specialty of his/her choice of subject, leading to a
masters degree – MDS.
26
DEVELOPMENT OF THE DENTAL PROFESSION
Dental diseases have always afflicted human health.
The first written evidence on dentistry is by Pierre
Fauchard in 1728.
Even the well known dentist G.V. Black had possessed a
formal education of dentistry in just 20 months.
Baltimore college of dental surgery (1840) was the first
dental college in world. Later known as University of
Maryland.
27 First journal of dentistry was ‘The American
Journal of Dental Sciences’.
The first Organization was named ‘The American
Society of Dental Surgeons’.
The first census was in 1850 in the US which
showed a dentist: population ratio of 1:8000.
28
DENTAL PROFESSION IN INDIA
Dr. Rafiuddin Ahmed started the first dental college
in Calcutta in 1920.
At the time of independence, there were only 2
government institutions,
Lahore and Bombay, and there were 19 private
institutions such as
29
Nair dental college (Bombay) and The Calcutta
college.
Presently, there are 309 dental colleges in India.
30 The World Health Organisation recommends a 1:
7500 dentist to population ratio whereas the dentist
to population ratio in India is as low as 1:22500. (World Health Organization: Recent advances in oral health. In Technical Report Series-
826. World Health Organization; 2012:1-37.)
In 2014, India had one dentist for 10,000 persons in
urban areas and about 2.5 lakh persons in rural
areas. (India Ministry of Health and Family Welfare and Dental Council of India. Status of dental
colleges for admission to BDS course. At:http://mohfw.nic.in/Adental.html.)
31
Almost three-fourths of the total number of
dentists were clustered in urban areas, which
house only one-fourth of the country's
population.
(Tandon S: Challenges to the Oral Health Workforce in India. J Dent
Education 2004, 68:29-33.)
32
DENTAL AUXILIARY
33
Dental auxiliary is generic term for all persons
who assist the dentists in training patients.
34WHO Definition (1958)
A dental auxiliary can be defined as ‘A person who is given
responsibilities by a dentist so that he or she can help the
dentists render dental care, but who is not himself or herself
qualified with a dental degree’.
The duties undertaken by dental auxiliary range from simple
tasks such as sorting instruments to relatively complex
procedures which form part of the treatment of patients.
35CLASSIFICATION OF DENTAL AUXILIARIES:
Dental auxiliaries may be classified according
To the training they have received,
The task they are expected to undertake,
The legal restrictions placed upon them.
While different titles have been given to groups
of auxiliaries classified in this way, terminology
is not consistent from one country to another.
36 Therefore, unless standard definitions are
provided of what constitutes a dentist, a dental
therapist, or any other dental health worker,
national and international statistics cannot be
comparable and meaningful.
International Labour Organization and by
the conference conducted by the World
Health Organisation in New Delhi in 1967
37
WHO CLASSIFICATION
NON OPERATING AUXILIARIES
a) CLINICAL - a person who assists the dentist in
his clinical work but does not carry out any
independent procedures in the oral cavity.
b) LABORATORY - a person who assist the
professional (dentist) by carrying out certain
technical laboratory procedures.
38 OPERATING AUXILIARIES
This is a person who not being a professional
is permitted to carry out certain treatment
procedures in the mouth under the direction
and supervision of a professional.
39
REVISED CLASSIFICATION Slack GL, Burt BA (1981)
NON OPERATING AUXILIARIES Dental surgery assistant Dental secretary/ receptionist Dental laboratory technician Dental health educatorOPERATING AUXILIARIES School dental nurse Dental therapist Dental hygienist Expanded function dental auxiliaries
40
FUNCTIONS OF DENTAL AUXILIARIES
Performing oral prophylaxis
Providing health education
Applying anti cariogenic agent
Placing & removing rubber
dams
Placing & removing matrices
Placing & removing temporary
restorations
Placing, carving & finishing
amalgam restorations
Office & chair side assistance
Assisting in radiographic
exposure
Taking impressions for study
casts
Removing sutures & dressing
Applying topical anesthetics
Performing preliminary oral
examination
41 Non – Operating Auxiliary.
Dental surgery assistant
Dental secretary / receptionist
Dental laboratory technician
Dental health educator
42 DENTAL SURGERY ASSISTANT
Dental assistants are an invaluable part of the
dental care team.
Enhancing the efficiency of the dentist in the
delivery of oral health care and
Increasingly influencing the productivity of
the dental office.
43HISTORY OF DENTAL ASSISSTANT:
The introduction of anaesthesia in dentistry after
1850 is one of the reasons for dentists requiring
the presence of an dental assistant and to act as a
helper for female patient.
In 1885, Dr. Edmund Kells of New Orleans
hired the first woman dental assistant to replace
his male "helper".
44
He has generally been credited as the
founder of the dental assisting profession.
This aptly-named "lady in attendance" made
it acceptable for a respectable woman to seek
dental treatment without her husband.
45 Dr. Kells then realized that the "lady in
attendance" could be helpful in office duties, as
well as in facilitating dental health care delivery
for women.
By 1890, he routinely employed women as both
chair side and secretarial assistants.
46
DUTIES ASSIGNED TO DENTAL ASSISTANTS
Reception of patient.
Preparation of the patient for any treatment he or
she may need.
Preparation and provision of all necessary
facilities, such as mouthwashes, napkins.
47
Sterilization care and preparation of instruments.
Preparation and mixing of restorative materials
including tooth filling and impression materials.
Care of patients after treatment until he or she
leaves.
48 Preparation of the surgery for the next patient.
Presentation of documents to the surgeon for his
completion and filling of this.
Assistance with extra work and processing and
mounting of x-rays.
Instruction of the patient, where necessary, in the
correct use of the toothbrush.
(Auxiliary Dental Personnel. World health Organization. Technical report
series. No. 163)
49 The candidates are expected to have had a
secondary education and a formal course of
training of one year’s duration is required.
Curriculum
• The importance of ethical behavior
• Principles and methods of sterilization
• Preparation of filling and impression materials
50 Four Handed Dentistry
51RESULTS TO BE EXPECTED WITH THE HELP OF DENTAL ASSISTANT
1. More dental-care services can be provided
through use of a trained assistant because she
conserves the dentist's time by performing the
numerous tasks incident to routine dental
treatment, which the dentist would otherwise
have to perform himself.
2. Quality of services is also improved.
52
3. The necessary armamentarium is as near as
the dentist's hand. He can work from the
seated position during the entire treatment
procedure, and be less fatigued.
53
DENTAL SECRETARY / RECEPTIONIST:
This is a person who assists the dentist with his
secretarial work and patient reception duties.
54DENTAL LABORATORY TECHNICIAN
The dental technician, whose main function is the fabrication
of appliances, should work according to the prescriptions and
under the supervision of the fully qualified dentist.
55 Dental laboratory technology is both a science
and an art. Since each dental patient's needs
are different, the duties of a dental laboratory
technician are comprehensive and varied.
Although dental technicians seldom work
directly with patients, except under the
direction of a licensed dentist, they are
valuable members of the dental care team.
56
Functions of the dental technician would include:
The casting of models from impressions of patients’ mouths.
The construction of appliances based on these models from
the dentist’s prescription.
The treatment of metals and of plastic materials used in
construction of these appliances.
The construction of splints used in faciomaxilliary surgery.
(Auxiliary Dental Personnel. World health Organization. Technical report series. No. 163)
57
The construction of orthodontic appliances to the
dentist prescription.
The keeping of dental stores.
The expert committee emphasize the dental
technician should not take impressions of the mouth
and that he should not have contacts with patients.
(Auxiliary Dental Personnel. World health Organization. Technical report series. No. 163)
58 Training of the dental technician
• Candidates for training should have a standard
of basic education sufficient to support their
technical study.
• This basic education should include secondary
education.
59
Training period of the dental technician
The World Health Organisation Expert Committee
considers 3 years of training, desirable.
This should not be less than two years and if
possible should probably be extended over a period
of three years.
The course should be followed by a period of
practical work in a laboratory before the trainee
receives license.
60
Curriculum:Instructions in basic principal of chemistry and
physics that relate to the needs of dental laboratory technicians.
Instruction in the use and care of tools, implements and equipment that are important to the dental laboratory technician.
Instruction to those techniques that are used in fabrication of Full dentures.Partial dentures.Ceramics.Porcelain work.Crown and bridge work, Orthodontic appliances.
61 DENTURIST Denturist is a term applied to those dental
laboratory technicians who are permitted to
fabricate denture directly for patient without
dentist’s prescription
Dental services were included in the health plan
of one of the first systems of health insurance in
the world, a system introduced in 1883 in
Germany.
62
Because of shortage of dental personnel, legislation was
passed in 1914 in German Imperial Diet permitting dental
laboratory technician to work directly with the public in
supplying complete denture.
But later quality of work declined; hence in March 1952
Federal Republic of Germany enacted legislation confining
the practice of dentistry to fully trained and qualified dentists.
63
During same time due to shortage of trained dental technician in
Canada, many technicians from Germany moved to Canada and
they began working directly with the public.
They organised a denturist society across Canada and began a
legislative battle to gain professional recognition and legal
status.
Denturists in the United States, encouraged by the successes in
Canada, began to organize similar efforts in the various state
legislations to legalize denturism.
64 First denturist type legislation was filled in Illinois in 1955. In
the period 1977-1980, denturism became legal in Maine,
Arizona, Oregon and Colorado.
The arguments over denturism have generated great
controversy in many countries where denturism legislation has
been introduced.
DENTURISM has been defined by the American Dental
Association as "the unqualified and illegal practice of
dentistry".
(Waterman GE; Effective use of dental assistant; public health report; Vol. 67, No. 4, April 1952; 390-394.)
65
On the other hand, the National Denturists
Association, the organization of U.S. dental
laboratory technicians seeking to be licensed
independently, describes a denturist as "a highly
skilled laboratory technician who has devoted his
lifetime to the making of full and partial dentures".
66 The divergence in these two definitions
reflects the controversy surrounding the
concept of denturism and its practice. (Flanders RA; The denturism initiative; Public health reports; Sept-
Oct 1981; Vol 96, No 5; 410-417.)
67Denturists are now practising in many developed as
well as underdeveloped countries.
Reason behind denturism in developed countries
like United States,
low cost of denture to needy people who are
old,
no provision for denture in Medicare;
people think dentists are middle person for
giving denture.
68DENTAL HEALTH EDUCATOR
In few countries duties of some dental surgery
assistants have been extended to allow them to
carry out certain preventive procedures.
In Sweden, two additional weeks of training are
given after which the auxiliaries are allowed to
conduct fluoride mouth rinsing programmes to
groups of children.
69
In the United Kingdom, a small group of
dental health education officers are employed
as number of local authorities and practices to
educate in matter of prevention
In Finland personnel with greatest oral health
education (OHE) work load are dental
assistant and dental hygienists.
70 They teach modern theories of health education,
emphasizing on the factors that strengthen self
confidence and the power of the patient to
decide for her/himself, rather than merely
presenting him/her with information.
71OPERATING AUXILIARY
School dental nurse Dental therapist Dental hygienist Expanded function dental ancillaries
72
THE NEW ZEALAND SCHOOL DENTAL NURSE
The New Zealand school dental nurse plan was introduced in
1921.
During World War I (1914-1918), extensive dental disease were
observed in army recruits and dentists were in short supply.
Hence in 1921 first training school for dental nurse was opened
in wellington, New Zealand.
This school came into being at the urge of Sir Thomas Hunter, a
founder of the New Zealand dental association and a pioneer in
the establishment of a dental school in New Zealand.
73 Hunter knew of the success of the dental hygienist in United
States and saw in these women means of correcting the
deplorable defects he saw in the teeth of New Zealand children.
In 1923, 29 dental nurses were graduated from the wellington
school.
The dental nurse is employed only by the government.
The dental service offered to children begins at the age of two
and one-half years.
When child reaches the age of thirteen he is discharged from the
services of dental nurse.
74 School Dental Nurse
Functions of School Dental Nurse General
Maintaining a specific group of approximately 500
children in sound dental health and free from dental
defects by examining and treating them at six
monthly intervals.
Teaching the principles of oral hygiene, using
modern teaching and publicity methods, and gaining
the interest and cooperation of the children and their
parents in this matter.
75
76 Specific
Examining patients and charting the dental
condition
Performing prophylaxis.
Placing fillings in both permanent and
deciduous dentition.
Extracting teeth under local anesthesia.
Making topical application of preventive
medicaments.
77
Recognizing malocclusion and lesions whose
treatment is beyond her scope, and referring them to
a dentist.
Giving special attention to teaching the principles of
oral hygiene and prevention of dental disease not
only to individual children but also to school
classes, teachers, women’s organization, parent –
teacher association and similar bodies.
78
• Training of nurse
The object of training should be to produce personnel
who are capable of maintaining specific groups of
preschool and school children in a state of sound dental
health by means of treatment in a restricted field given
at regular and frequent intervals and by instructions in
the principles of oral hygiene.
School dental nurse work under the direction and
control of dental surgeons. Training period of nurses
A minimum of two calendar years
79
Curriculum of nurses
Special instructions in the principle of teaching and
public speaking, visual education, and the
preparation of models and posters for health
education.
Instruction in the history of dentistry, the history
and ethics of nursing, and the role of various
organizations that are concerned with the promotion
of child health. (Puder EE. THE NEW ZEALAND DENTAL NURSE. American Journal of Public Health.1970 (60); 7:1259)
80
SCHOOL DENTAL NURSE PROGRAMS IN OTHER COUNTRIES
The New Zealand school dental nurse plan has attracted
tremendous attention in dental circle all over the world. Many
countries has adopted same concept or modified according to
local environment.
New Zealand program is expanded well into Southeast Asia
under support of world Health Organisation and Colombo
Plan, which includes many countries such as Ceylon, Malaya,
North Borno, Thailand, Indonesia, Hong Kong, New Guinea,
Ghana, Australia and England.
Canada imported New Zealand Dental Nurse model since
1971, trained at the community college level.
81
DENTAL THERAPIST
These auxiliaries, earlier called dental dressers,
were employed in the school dental service in parts
of Great Britain.
Their training and employment were opposed by the
dental profession and the scheme was abandoned in
1925.
The scheme was again introduced in 1960 in
response to a shortage of dental manpower.
82 Dental therapist is more conserved term than
dental nurse as they work under direct
supervision dentists .
Dental therapists in Canadian armed forces are
permitted to organize and conduct dental
inspections and to categorize patterns into
priority order.
83
Person who is permitted to carry out certain
specified preventive and treatment procedures on
the prescription of a dentist including the
preparation of cavities and restoration of teeth.
They are like school dental nurse but their role is
quite different, they are not permitted to diagnose
and plan dental care. They are permitted to work
based on the written treatment plan by the dentist.
84 The training of therapists is for a period of 2
years including the clinical training.
They can perform all functions as a school
dental nurse, but are not allowed to perform
endodontic procedures and interpretation of x-
rays.
In some countries, school dental nurse and
dental therapists are allowed to perform only
preventive work. .
DENTAL HYGIENIST
85
86 Dental Hygienist
Dr.Alfred Civilion Fones
Concept in early 20th century
In 1913 Fones Clinic in Bridge port.Worlds first Oral Hygiene School
1917 Irene newman receive first dental hygiene license
FATHER OF DENTAL HYGIENIST
87
DUTIES ASSIGNED TO DENTAL HYGIENIST
Scaling and polishing teeth, • Applying fluorides,
and other preventive agents
• Educating patients to practice sound dental habits
Diagnostic data collection• Desensitization of
teeth after scaling and polishing
• Radiographs• Bleaching of
teeth
Occlusal splints• Sealant placement• Preventive
appointments.
88 Colorado has no restrictions on hygiene practice
and a dental hygienist may be an owner, but
these practices must have an agreement with a
dentist to provide direct supervision for local
anaesthesia and general supervision for X-rays.
New Mexico allows dental hygienists to engage
in collaborative practice based on written
agreement with one or more consulting dentists.
89 ROLE OF DENTAL HYGIENIST AS DENTAL HYGIENE PUBLIC HEALTH
Fales HM (1958) suggested three levels of competence within the groups of dental hygienist working in public health; the certificate dental hygienist, the dental hygienist with bachelor’s degree and the dental hygienists with graduate training in
public health beyond the bachelor’s degree.
(Fales HM.The potential role of the dental hygienist in public health programs. American Journal of Public Health Dentistry 1958(48);8:1054-7)
90
A certified dental hygienist has
two years of technical training in dental
hygiene skills,
state board license, and
Is with or without experience. (Fales HM.The potential role of the dental hygienist in public health programs.
American Journal of Public Health Dentistry 1958(48);8:1054-7)
91TRAINING OF DENTAL HYGIENIST
Dual role an auxiliary to the dentist in private
practice or as a member of public health team. Training period
2 to 4 years
It is thought that a minimum period of one
calendar year would be appropriate for countries
willing to introduce this type of personnel into
their health services.
92 Curriculum of Dental hygienist
Basic information on the structure and functions of
human body, with emphasis on oral cavity.
A special study of masticatory apparatus, including its
supporting structures and the macroscopic and
microscopic aspects of teeth.
Basic principles of chemistry and bacteriology to serve
as a foundation for the understanding of the causation of
dental caries, and a study of its prevention and control.
93
Topical application of medicaments
Study of the main chemical substances
Dental health education methods and materials
Oral prophylaxisMost common diseases of
the oral cavity
Brushing technique
Instruction of the patient at the chair
94EXPANDED FUNCTIONS DENTAL AUXILIARIES (EFDA)
The expanded-function dental auxiliary (EFDA) or
expanded-duty dental auxiliary (EDDA) is a more recent
development in operating auxiliaries in the United States
and Canada.
In EFDA is a dental assistant or a dental hygienist in
some cases, who has received further training in duties
related to the direct treatment of patients, though still
working under the direct supervision of a dentist.
95
The personnel could be trained to perform the
desired services within considerably shorter
periods of training than required for dental
practitioners.
96 One such study was done in the Division of Dental
Health of the Philadelphia Department of Public
Health; they termed them as ‘Dental
Technotherapists’.
The first large scale service application of the
expanded duty principle were made in Philadelphia.
They were called “Techno-Therapists”.
97 Placement and removal of rubber dam.
Placement and removal of matrices and wedges
Insertion of calcium hydroxide and/or other liners and cement bases
Condensation and carving of amalgam restorations
Finishing and polishing of all restorations
Positioning, exposing, developing and mounting of x-rays
Place silicate and plastic restorations and
Contour stainless steel crowns for full coverage
Take full mouth and partial alginate impressions
The initial duties of the technotherapists consisted of the following:
(Soricelli DA; Implementation of the delivery of dental services by auxiliaries-the Philadelphia experience; AJPH, 1972, Vol.62, No. 8; 1077-1087.)
98 D DUTIES UNDERTAKEN BY EXPANDED FUNCTION DENTAL AUXILIRY Applying topical fluorides Applying pit and fissure sealants Placing, carving and polishing amalgam restoration Placing and finishing composite restoration Placing and removing matrix band Placing and removing rubber dam Taking impression for study casts Exposing and developing radiographs Removing sutures Removing and replacing ligature wires on orthodontic
appliances.
99Frontier Auxiliaries
Nurses and former dental assistants can in such
areas, provide valuable service with the minimum
of training.
Simple prophylaxis can be performed
Basic health education
Dental first aid
Organise flouride rinse programs and simple
denture repairs.
100
1n 1981, one week training program was
conducted in Alaskan communities.
101
NEW TYPES OF DENTAL AUXILIARIES
Dental licentiate
Dental aides
102
NEW TYPES OF DENTAL AUXILIARIES
Some countries have an acute dentist shortage and have no
facilities for training dentists.
In 1958, the expert committee auxiliary dental personnel of
the World Health Organisation suggest two new types of
dental auxiliary for such situations;
Dental licentiate
Dental aide
103
To address oral health care workforce
concerns, several efforts are under way that
would expand the workforce by incorporating
new models of care as
Community dental health co-ordinator
Oral preventive assistant
Advanced dental hygiene practitioner
104
DENTAL LICENTIATE
Dental licentiate is the semi independent operator
trained for 2 years to perform.
Duties undertaken by dental licentiate, Oral prophylaxis. Cavity preparation and filling of primary and permanent teeth. Extraction under local anaesthesia. Draining of dental abscesses. Treatment of most prevalent diseases of supporting tissues of the teeth. Early recognition of more serious dental conditions.
105
DENTAL AIDE
Extraction of teeth under local anaesthesia,
Control of haemorrhage, and
Recognition of dental disease important enough to
justify transportation of the patent to a centre where
proper dental care is available.
The formal training extends from 4-6 months, followed
by a period of field training under direct and constant
supervision.
BENEFITS OF AUXILIARIES
With rapid population growth and increasing demand for
dental care, more and more dentists are required. But this is
an expensive process
Hence training an auxiliary is more economical, less time
consuming and fewer burdens to society
Results in definite benefits to dentists, patients, auxiliaries
and to whole community, financially, psychologically .
107
IMPACT ON INDIAN SCENARIO There exists a serious maldistribution of the dental
professionals with nearly 75% dentists practicing in urban
areas catering to 25% population.
Unfortunately, only auxiliary personnel who exist in India are
dental surgery assistant, laboratory technician and dental
hygienists.
They have to undergo a training of 2 years in institutions
which have been recognized by Ministry of Health;
Government of India and certificate course recognized by the
Dental Council of India.
108
The most suitable types for Indian set-up will be
school going dental nurse and EFDA
They can play a major role not only in providing
basic dental care but also in prevention of dental
diseases both for children and general
underprivileged population. * Dental manpower in India: current scenario and future projections for the year
2020 Sudhakar Vundavalli
With about 309 dental colleges in the country, almost
30,000 dentists graduate every year
One dentist per 10,000 people in urban India, however,
there is only one dentist per 1.5 lakh in rural India.
*International Dental Journal, April, 2014. 10.1111/idj.12063
Dental manpower in India: current scenario and future projections for the
year 2020 Sudhakar Vundavalli
International Dental Journal, April, 2014. 10.1111/idj.12063Dental manpower in India: current scenario and future projections for the year 2020 Sudhakar Vundavalli
The output of qualified dentists has increased substantially
over last decade and at present there are over 117,825
dentists working in India. Although India has a dentist to
population ratio of 1:10,271, the newly graduating dentists
find it difficult to survive in the private sector.
At present less than approximately 5% graduated dentists
are working in the Government sector.
Role of Dental College Administration
The dental institutions should take responsibility of
adopting population covering 3 PHCs in the rural areas as
well as schools, old age homes, orphanages etc in the
district.
Coordination with district administration.
Collaberate with other health programmes being run by the
Govt. to advocate common risk factor approach and the
programmes like maternal and child health care programs.
Role of DCI/ Govt. of India
The curriculum of UG students training needs to be framed in
a way that it reflects training in totality for field experiences
as well as planning and implementation of programs as per
the objectives of the course.
The Govt. should frame the policies and strategies for oral
health promotion. The policies should be incorporated in the
National Health Policy.
DCI should also help in organizing the oral health care
programs in local area with IDA, or any other local
governing body
129
CONCLUSION
The practice of dentistry involves a personal
relationship between the dentists, dental auxiliaries
and the patients.
Both dentist and auxiliary personnel try to
emphasize health education, to correct
misconceptions and to attack apathy about dental
health.
130
Because of their unique privileges granted to
them, the members of the dental profession
have the responsibility of providing a high
standard of service to their patients and they
should assume their duties freely and
voluntarily.
131
Previous Year Questions
Dental Manpower (Sumandeep Vidyapeeth 2012)
10 marks
Dental Manpower (Manipal 2010) 7 marks
Role of dental Auxiliaries (RGUHS 2011) 20
marks
Dental Auxiliaries (RGUHS 2003) 10 marks
132
REFERENCES
Puder EE. The New Zealand Dental Nurse. AJPH. Vol 60 (7). 1970. 1259-63.
Tandon S. Challenges to oral health workforce in India. Journal of Dental Education. Supplement 7. 2005.
Slack GL. Jong AK. Community Dental Health. Soben Peter . Essentials of Preventive and Community
Dentistry Hiremath SS. Textbook of Preventive and Community
Dentistry
REFERENCES
Guidelines for Meaningful and Effective Utilization of Available Manpower at Dental Colleges for Primary Prevention of Oro-dental Problems in the Country” (A GOI- WHO Collaborative Programme).
Challenges to the Oral Health Workforce in India Shobha Tandon, B.D.S., M.D.S.; Journal of Dental Education ■ Volume 68, Number 7 Supplement
Waltson et al. Assessing differences in hours worked between male and female dentists: an analysis of cross-sectional national survey data from 1979 through 1999. J Am Dent Assoc. 2004 May;135(5):637-45.
Beirne P, Forgie A, Clarkson J, Worthington HV. Recall intervals for oral health in primary care patients. Cochrane Database Syst Rev. 2007;(4):CD004346
Beazoglou T, Bailit H, Heffley D. The dental work force in Wisconsin: ten-year projections. J Am Dent Assoc. 2002 Aug;133(8):1097-104.
Brown JL. Dental Work Force Strategies During a Period of Change and Uncertainty. Journal of Dental Education.2001. 65 (12); 1404-16.
Beazoglou T et al. The importance of productivity in estimating need for dentists. J Am Dent Assoc 2002;133;1399-1404.
Camarago MB etal. Regular use of dental care services by adults: patterns of utilization and types of services. Cad Saude Publica. 2009 Sep;25(9):1894-906.
Lo EC et al. Utilization of dental services in Southern China. J Dent Res. 2001 May; 80(5) : 1471-4.
Khan AA, Sithole WD. Oral health manpower projection methods and their implications for developing countries: the case of Zimbabwe. Bulletin of the WHO, 69 (3): 339-346 (1991).
Mahal AS, Shah A. Implications of the growth of dental education in India. J Dent Educ. 2006 Aug;70(8):884-91.
Strauss RP. Sociocultural influences upon preventive health behavior and attitudes towards dentistry. Am J Public Health. 1976 Apr;66(4):375-7.
Healthy people 2010 - Understanding and Improving Health; U.S. Department of Health and Human Services; November 2000.
Strategies and approaches in oral disease prevention and health promotion; Richard G. Watt; Bulletin of WHO, September 2005, 83 (9)
Slack GL. Planning for manpower requirements in Dental Public Health in Dental Public Health. 2nd Ed;1981. John Wright and Sons.
Dunning JM. Principles of Administration in Principles of Dental Public Health. 3rd Ed.
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