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Dental News

Saveetha Dental College & Hospital is the first hospital to complete 10000 implant surgeries in the country

by Pragati Singh September 10, 2021

written by Pragati Singh

Tamil Nadu, Chennai, India (NewsVoir) Saveetha Dental College and Hospital today announce that 10,000 implantation procedures have been successfully performed with an average success rate of 99.6 percent, the highest in the country. On the morning of 7 September 2021, the hospital also revealed that the team completed a 10000th operation.

On celebrating this landmark achievement, Saveetha Dental Hospital is inaugurating “SMILING FACES” a free awareness and screening campaign for implant treatment. Dr. Deepak Nallaswamy, Director Saveetha Institute of Medical and Technical Sciences said, “In India Prevelance of edentulism (patients with missing teeth) is 16.3% that is 22,75,25,961 patients are in need of teeth replacement. With missing teeth, there are a host of other things that you miss too. Things like your natural smile or not being able to eat the food that you desire or just missing the taste of life itself. One may also experience muscle strains and discomfort as the remaining teeth shift. Dental Implants at saveetha are the most effective tooth replacement option and cost effective too. Most dental Implants cost INR 30,000 to 60,000 in most centres.

Although our facility is the most sophisticated in the country, we offered these implants free of cost for the past 8 years. Even if we take the lower end of the charges, the value of free therapy done by the centre is more than 32 Crores, even the material charges were completely subsidised by the institution. Saveetha is proud to make such high end therapy accessible to the most economically challenged sectors of the society.” “In addition, People who have just recovered from COVID-19 it will beneficial to get checked for mucormycosis (Black Fungus). Black fungus has a high spreading potential and if not treated in time especially in diabetic patients. In most cases, surgery is required by removal of the infected bone before the fungus could damage other parts along with antifungal medications. Early detection is important,” said Dr. Deepak.

“It is a proud moment and congratulations for all the dental doctors for achieving this milestone, At Saveetha Dental College and Hospital Implantology Department has infrastructure worth 20 crores dedicated for implant therapy. 10,000 sq. ft. centre with 50 dental surgeons, 12 physio-dispensers, most advanced real-time navigation surgery, sophisticated software, 3D printers, CBCT and many advanced surgical facilities. and many advanced surgical facilities making it the go to destination of quality, subsidised implant therapy,” said Dr. NM Veeraiyan, Founder and Chancellor Saveetha Institute of Medical and Technical Sciences. Saveetha Dental College is the first education institution to incorporate implant training for under graduates (UG).

Also postgraduates and practitioners from other institutions join for training after degree completion; So far more than 500 foreign practitioners were trained at saveetha dental campus. Image: 10000th Implant surgery at saveetha Dental College and Hospital PWR PWR

September 10, 2021 0 comment

Dental News Experts speak

Oral health of utter significance, even amid Pandemic

by Dr (Hony) Brig. Anil Kohli September 1, 2021

written by Dr (Hony) Brig. Anil Kohli

The Coronavirus pandemic has reinforced the need to ensure a healthy lifestyle and concentrate on prevention of diseases that play a pivotal role in the health of an individual. However, while ensuring a proper diet, regular exercise and mental health have all been talked about, but one area that seems to have been neglected is oral health, which should not be the case. A number of problems in the body manifest or can be traced down to poor dental hygiene which can be a big problem in the long run. And with frequent restrictions being put in place to tackle the pandemic, which often result in either cancellation or a delay in regular appointments with the dentist, people should be taking special care of their oral health.

To better understand the importance of oral health and what steps individuals should be taking to maintain it, Dr (Hony.) Brig. Anil Kohli, recipient of the Padam Shri, Padma Bhushan and Dr B C Roy Award, shares his valuable insights. To begin with, Brig. Kohli stresses upon the importance of oral health, saying that prevention is better than cure, therefore stressing that precautions should be taken. “Follow the routine dental care at home like – Brushing twice daily, using mouthwash and flossing,” he says. And when it comes to individuals who have tested positive for the Coronavirus, these precautions become even more important. Brig. Kohli says that “If the patient has been infected with the Coronavirus, then post recovery it is advisable to discard the old toothbrush and use a new one. One must regularly disinfect the toothbrush by first disinfecting the handle with 70% alcohol for one minute and then immersing the bristles in ethanol and oil based mouthwash solutions for 20 minutes. One can opt for tele-dentistry and have online consultation with the dentist. The doctor will let you know whether you can delay the visit and also tell you the appropriate measures one can take while at home”.

Patients should also take special care when dealing with the virus at home, “Good oral hygiene is not only important for healthy teeth and gums but also for the overall well being of an individual. Failing at which increases bacterial levels in the oral cavity that can increase the chances of having heart and lung diseases. Thus it is necessary for the infected person to have good oral health to decrease the severity of the symptoms,” says Brig. Kohli.

Beyond the immediate impact of the pandemic on dental health, there are signs that are often overlooked but can turn into bigger problems when it comes to oral hygiene as well. “Like any other systemic disease, Covid-19 and oral health are interlinked. Not only does the severity of Covid-19 increase in patients with poor oral health, even the existing oral problems worsen in patients with Covid-19 infection. In both the cases, one has to be observant and vigilant and follow the progress of the symptoms. If one observes that the symptoms are worsening, one must contact the oral health care provider. Apart from taking the measures explained above for a good oral health care regime at home, a regular follow up post recovery is a must,” stresses Brig. Kohli.

And the special care does not end with individuals testing negative for the virus. Even after people are no longer infected, it is important to take special precautions to ensure that there is no lasting impact of the virus on the body. “A lot of things have changed post the starting of Covid-19 pandemic. It has reminded all of us about the pivotal role hygiene plays in prevention of most of the diseases. The focus has shifted from curing to prevention of the disease. Here are some of the measures one can adopt daily for good oral health –

Brush twice daily
Use of fluoride toothpaste
Include flossing in daily routine
Use of Mouthwash
Drink water regularly
Avoid sticky foods
Regular dental visit every 6 months.

Though the pandemic is pressing down upon us all, altering the way we live and forcing us to accept the new normal where social distancing is the norm, there are certain emergencies when it comes to oral health that should on no account be ignored or medical attention delayed. Some of these emergencies that Brig. Kohli talks about, that require immediate medical attention include-

Swelling of your gum, cheek or face which is increasing in size and spreading

Excruciating pain resulting in lack of sleep

Mouth ulcers not healing beyond 2 weeks

Bleeding lasting for more than 20 minutes post extraction and can’t be stopped by biting on a hankie/gauze

A broken tooth causing pain and damage to your cheek or tongue

Controlled bleeding due to facial trauma

Taking appropriate home care measures but still but the pain is getting worse

Apart from these, the frequency of fungal infections has increased remarkably during Covid-19. This can be attributed either to the immunodeficiency of viral infections or because of the use of immunosuppressive drugs to treat Covid-19. Also the increased tendency for dry mouth can alter the oral microbial flora, resulting in pathogenic fungal elements to grow. These oral fungal infections are associated not only with greater discomfort but also lead to destruction of tissues beyond repair if not diagnosed timely. The symptoms that the patient needs to look after carefully are – swelling or bleeding of the gums, pus discharge from the gums, white/yellow/black plaque areas on the tongue or any where in the mouth, sudden loosening of the teeth, pain or discomfort around the nose, eye or forehead that may resemble sinusitis pain. These symptoms need to be addressed as early as possible for better prognosis.

Despite the current constraints and changes in the way we approach and tackle health related problems, as Brig. Kohli says for oral health, prevention is better than cure, there are some home remedies and precautions that every individual should be taking note of to prevent a last minute dash to the doctor. The foremost measure one must take says Brig. Kohli “is brushing twice daily. Including use of mouthwash, fluoridated toothpaste and floss in daily practice can help prevent a lot of dental problems. One must avoid sticky foods and keep one hydrated to prevent dental caries”.

September 1, 2021 0 comment

Covid News and Updates Dental News

DCI issues new guidelines amid coronavirus case surge

by Vaishali Sharma April 30, 2021

written by Vaishali Sharma

The Dental Council of India (DCI) has issued guidelines for dental colleges, dental students and dental professionals enlisting measures to prevent transmission, reduce the impacts of the outbreak, and support control measures.

The measure are as follows for:

Undergraduates and interns –

All Dental Colleges should abide to current situation and work from home, which is based on various Office orders or notifications of the Government of India, State Governments, Statutory Bodies and District administration. Professional Educational Institutions have been asked to close completely or asked to suspend classes and offer teaching learning using technology and working from home.
Similarly several guidelines have been given by the Government of India and its autonomous bodies to use various learning resources, technology platforms and innovative teaching approaches. The students have been advised to study from home, maintain social distancing and restrict their movements from their present place of stay.
The Principals I Heads of the Institutions of Dental Colleges are hereby advised to take essential steps and put up the necessary schedule and structure in place so that the faculty are able to engage in online teaching to the dental students and complete the curriculum through remote teaching for as long as the Institutions have been asked to remain closed by the Government and the District authorities in different parts of the country.
The Principals / Heads of the Institutions of Dental Colleges may share the learning resources in advance through their website, email to students and other learning apps I platforms that are available in this regard. The Institutions /Faculty may document the details of classes taken, the students engaged, the percentage of attendance, assignments given and their assessment.
The Principals I Heads of the Institutions of Dental Colleges may develop standardised video demonstration materials using various virtual platforms for all dental students.
The examining authorities are also advised to take cognizance of the same towards fulfilment of academic requirements for allowing a student to take up examination.
The Principals I Heads of the Institutions of Dental Colleges may direct all departments to maintain attendance and record of assignments given to the students.
Dental Colleges should encourage students to engage in self-learning, make full use of online resources and learn about the latest academic developments.
The Principals I Heads of the Institutions of Dental Colleges should facilitate and provide access to E-library facility to all dental students.
During this period, it is easy for students to be affected by disease associated fear and pressure, dental colleges should be prepared to provide professional psychological services to those who need them.
The Principals and the Head of the Institutions are required to submit the details of the efforts taken by them in extending teaching modules which have been utilised during this time in an objective manner.

Interns related postings –

All Interns may not have the opportunity to complete their compulsory rotary one year internship in compliance with regulations due to the prevailing health emergency conditions and decisions may be taken in accordance to various Office orders or notifications of the Government of India, State Governments, Statutory Bodies and District administration.
This recommendation is proposed with the objective of letting the passing out graduates to pursue career ambitions without loss of time and delay in obtaining the academic qualifications.
During this period, all interns are assessed for disease associated fear and pressure. Dental colleges should be prepared to provide psychological services to those who need them.
Dental Colleges should encourage Interns to engage in self-learning, make full use of online resources like webinars and learn about the latest academic developments.

POST GRADUATE STUDENTS ACADEMIC ACTIVTIES:

1. All routine academic activities like Seminars, Journal Clubs and other discussions may be carried out using various learning resources, technology platforms and innovative teaching approaches.

2. The Department may document the details of academic activities conducted, the students engaged, the percentage of attendance and assignments given and their assessment.

CLINICAL ACTIVITIES

1. All routine clinical activities of all specialities are deferred and for emergency dental care, follow the guidelines mentioned below.

2. Reappoint previous ongoing patients till further notice and keep a record of the same.

THESIS RELATED WORKS: Keeping in view that the students who are registered for M.D.S. Course and are in the process of conducting their thesis and may not, be able to submit in time or able to appear for examination before the examiner in person in the present circumstances the Dental Council of India recommends that

1. The student and the Guide may determine whether the work done for the thesis is in compliance with regulatory requirements and complete the follow up as remotely as possible. Any clinical follow up should be deferred and organised at a more appropriate time. The same should be noted and mentioned in all records.

2. The submission of thesis will be deferred in accordance to the existing situation and the local examining university or authority will decide upon and provide necessary timelines.

To view the official notice, click on the following link:

https://www.dciindia.gov.in/Admin/NewsArchives/L.No.%20331.PDF

April 30, 2021 0 comment

Dental News

Heart infection from mouth bacteria can be prevented by good dental health

by Vaishali Sharma April 17, 2021

written by Vaishali Sharma

The most important ways to reduce risk of a heart infection called infective endocarditis caused by bacteria in the mouth, can be prevented by good oral hygiene and regular dental care. There are four categories of heart patients considered to be at highest risk for adverse outcomes from infective endocarditis, and only these patients are recommended to receive preventive antibiotic treatment prior to scientific procedures.

Taking care of oral health is more important than use of antibiotics in dental procedures for some heart patients to prevent a heart infection caused by bacteria around the teeth according to a new American Heart Association (AHA).
Infective endocarditis (IE), also called bacterial endocarditis, is a heart infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel. It is uncommon, but people with heart valve disease or previous valve surgery, congenital heart disease or recurrent infective endocarditis have a greater risk of complications if they develop IE. Intravenous drug use also increases risk for IE. Viridans group streptococcal infective endocarditis (VGS IE) is caused by bacteria that collect in plaque on the tooth surface and cause inflammation and swelling of the gums. There’s been concern that certain dental procedures may increase the risk of developing VGS IE in vulnerable patients.

The new guidance affirms previous recommendations that only four categories of heart patients should be prescribed antibiotics prior to certain dental procedures to prevent VGS IE due to their higher risk for complications from the infection:
Those with prosthetic heart valves or prosthetic material used for valve repair;
Those who have had a previous case of infective endocarditis;
Adults and children with congenital heart disease; or
People who have undergone a heart transplant.
“Scientific data since the 2007 AHA guidelines support the view that limited use of preventive antibiotics for dental procedures hasn’t increased cases of endocarditis and is an important step at combating antibiotic overuse in the population,” said Walter R. Wilson, M.D., chair of the statement writing group and a consultant for the Division of Infectious Diseases, Department of Internal Medicine at Mayo Clinic in Rochester, Minn.

It has been over a decade since recommendations for preventing infective endocarditis were updated amid concerns of antibiotic resistance due to overprescribing. The American Heart Association’s 2007 guidelines, which presented the biggest shift in recommendations from the Association on the prevention of infective endocarditis in more than 50 years, more tightly defined which patients should receive preventive antibiotics before certain dental procedures to the four high-risk categories. This change resulted in about 90% fewer patients requiring antibiotics.

The scientific statement writing group reviewed data on VGS IE since the 2007 guidelines to determine if the guidelines had been accepted and followed, whether cases of and mortality due to VGS IE have increased or decreased, and if the guidance might need to be adjusted.

The writing committee reports their extensive review of related research found:

There was good general awareness of the changes in the 2007 guidelines, however, adherence to the guidelines was variable. There was about a 20% overall reduction in prescribing preventive antibiotics among high-risk patients, a 64% decrease among moderate-risk patients, and a 52% decrease in those patients at low- or unknown-risk.
In a survey of 5,500 dentists in the U.S., 70% reported prescribing preventive antibiotics to patients even though the guidelines no longer recommend it, and this was most often for patients with mitral valve prolapse and five other cardiac conditions. The dentists reported that about 60% of the time the antibiotic regimen was recommended by the patient’s physician, and 1/3 of the time was according to patient preference.
Since the stricter 2007 antibiotic guidelines, there is no convincing evidence of an increase in cases of VGS IE or increased mortality due to VGS IE.

The writing group supports the 2007 recommendation that only the highest risk groups of patients receive antibiotics prior to certain dental procedures to help prevent VGS IE.

In the presence of poor oral hygiene and gingival disease, VGS IE is far more likely to develop from bacteria attributable to routine daily activities such as toothbrushing than from a dental procedure.

Maintenance of good oral hygiene and regular access to dental care are considered as important in preventing VGS IE as taking antibiotics before certain dental procedures.

It is important to connect patients with services to facilitate access to dental care and assistance with insurance for dental coverage, especially in those patients at high risk for VGS IE.

It is still appropriate to follow the recommendation to use preventive antibiotics with high-risk patients undergoing dental procedures that involve manipulation of the gum tissue or infected areas of the teeth, or perforation of the membrane lining the mouth.

The scientific statement was prepared by the volunteer writing committee on behalf of the American Heart Association’s Young Hearts Rheumatic Fever, Endocarditis and Kawasaki Disease Committee; the Council on Lifelong Congenital Heart Disease and Heart Health in the Young; the Council on Cardiovascular and Stroke Nursing; and the Council on Quality of Care and Outcomes Research.

April 17, 2021 0 comment

Dental News

Importance of MILK TEETH & DECIDUOUS TEETH

by Medically Speaking Team March 11, 2021

written by Medically Speaking Team

by Dr Shweta Verma senior Dentist

Milk teeth starts erupting when the baby is around 6 months old . All the Deciduous teeth (milk teeth) erupts completely till 2 ½-3 years of age. Many people assumes that cavities or hygiene of milk teeth is not much importance as they will shed off eventually but milk teeth are really important for the overall health of the child .

loss of milk teeth or painful carious teeth discourages the child to eat or chew food properly, that leads to malnutrition in kids.
Smiling face is a confidence booster. Kids with carious teeth or broken milk teeth sometimes doesn’t interact confidently .
Milk teeth guides the eruption of permanent teeth. Permanent teeth may erupts in open space either outward or inward the arch, if milk teeth is lost due to caries or trauma.

Here are some common problems associated with milk teeth :

Nursing bottle caries: This is also called baby bottle tooth decay. It is caused when a child goes to bed with a bottle filled with milk or juice. It usually affects children between the ages of one and two years. Breastfed infants who fall asleep while breastfeeding are also at risk. Usually upper and lower front teeth are involved. Light or brown color spots leads to further decaying of teeth.

Precautions and treatment;

Do not allow your child to take bottle while sleeping or lying down.
Take good care of gums and teeth.
In case or light brown and brown spots, visit a dentist and get the carious teeth restored (filling) done. This will prevent the teeth from further damage.

Dislocation of teeth due to trauma

In many cases, a loose tooth will heal without treatment. Injured teeth that are very loose may need to be removed. Dentist will further guide about space maintainers ,if necessary, for the proper positional eruption of permanent teeth.

Fracture of teeth

Children with broken teeth should see a dentist promptly. The dentist will determine if the tooth’s nerves or blood vessels could be damaged. Treatment may include smoothing the rough edges of the tooth, repairing it with a tooth-colored resin material, leaving the tooth in place, or removing it.

Thumb sucking

If the child is still sucking their thumb even when their permanent teeth begin to come in, the habit can cause a wide range of other problems , affecting teeth alignment and the shape of roof of the mouth. In that case, dentist can provide a habit breaking appliances depending on the severity of habit and its effects.

Grinding of teeth (Bruxisim)

Teeth grinding is a common condition among school-aged children. It develops because their top teeth aren’t aligned with their bottom teeth. Another reason could be in response to pain — just as you rub a sore muscle, like teething or an earache. It can also be a sign that a kid is experiencing stress or hyperactivity. Night guards can help keep your child from grinding their teeth as they sleep.

Over retained deciduous teeth

Delaying in shedding of milk teeth / delayed eruption of permanent teeth/ presence of both milk and permanent teeth at the same site. In these cases, visit your dentist to rule out the possible cause and treatment related to that.

When is the right time for orthodontic braces or wiring of teeth ,in cases of crowding or mal-aligned teeth in children?

The best age for an orthodontic assessment of children is around 8-10 year of age, it helps to avoid progressive dental issues, helps in keeping better oral hygiene and accordingly braces can be planned after 1-5 years.

For adults , orthodontic treatment can be done at any age.

Oral hygiene tips for children

Baby teeth start to break through the gums around 6 months but it is important to start good oral care for infants even before the first tooth comes in.
Wipe your baby’s gums with a soft washcloth after feeding. This helps remove the bacteria that can cause tooth decay.
Once they begin to erupt, brush teeth twice a day for at least two minutes with a fluoride toothpaste.
Use a pea-sized amount of fluoride toothpaste and make sure your child spits it out after brushing.
Use a small or medium size brush ,according to the kids age and change the brush after every 3 months.
Help your child brush and floss, and remind him or her to pay attention to the back teeth.
Visit the dentist every 6 months.

The writer is Dr Shweta Verma, Senior Dentist, AIIMS.

March 11, 2021 0 comment

Dental News

Dental implants- Myth & Facts

by Medically Speaking Team February 12, 2021

written by Medically Speaking Team

By Dr. Dheeraj Kumar Koli

Dental implants are screw shape devices used for anchorage for dental prosthesis i.e. crown, dentures inside the mouth. They are made of titanium alloy and serves as a replacement for the root of missing tooth. They are used in adults of all ages for the replacement of teeth missing due to trauma, decay, or if an individual born without teeth. An abutment is connected to the implant fixture and over the abutment; a tooth cap or denture was fixed to provide the functions. Once they are placed in the jaw bone, they form a bond with the bone and provide rigid base support for artificial teeth replacement. They are indicated in adolescents once the facial growth is completed i.e. 16year for girls and 18 years for boys. Dental implants result in the restoration of the masticatory and cosmetic function of the individual so that the individual can enjoy his life confidently.

Q. How much time it takes to replace the teeth with the help of a dental implant?

A. Every patient depending on their need, medical and dental history and the health of supporting jawbones requires a customized treatment strategy. It can be 4 to 6 months for simple cases and up to 1 year for complex cases.

Q. Is dental implant treatment is safe.

A. Dental implants are a safe and effective procedure for the last 30 plus years. The implant dentist should educate the patient regarding the effect of certain medical conditions and habits like smoking which affect the success and prognosis of dental implants. Qualified dentists with highly competent skills will be able to manage the complications if any arises.

Q. Does dental implant is a painful procedure.

A. With the help of good anaesthesia the implant placement is relatively painless and the use of analgesic postoperatively reduces the discomfort and pain associated symptoms. Usually, patients return to their day to day activity from the next day post-implant placement.

Q. What are the steps for dental implant treatment?

A. Dental implant requires following steps –

Pre-treatment examination involving oral cavity examination, X-rays, and 3-dimensional evaluation of bone quantity and quality. Design a treatment plan specific to the situation.
Dental implant placement under anaesthesia and management of post-operative symptoms like pain, mild swelling, and discomfort by the use of medicine.
It will take few months (3 to 6months) so, that firm bond formation between implant and bone. During the healing phase, soft biting is allowed to prevent premature implant loading.
After implant healing and abutment connected to the implant fixture and a dental crown will be attached to it.
Maintenance of good oral hygiene and periodic check-up is required for the long term health of the implants.

Q. Dental Implants VS Fixed Bridge

A. Dental fixed bridge requires grinding of two adjacent teeth to provide support for the bridge for the missing tooth while a Dental Implant will be placed in the site of missing teeth without grinding the adjacent teeth. The ground teeth underneath the bridge have also become prone to decay and bone loss. So dental implants will be an effective way of restoring the natural smile.

Q. What are the different types of implants and techniques?

A. Dental implants are available in different sizes, shapes, and designs. The treating implant dentist will select the suitable implant type and the treatment for the clinical situations.

Q. What is the longevity of implants?

A. Dental implant longevity is good if the patients are following a good oral hygiene regime and regular follow-ups after dental implant therapy. The dental implant has a good survival rate of 15plus years if all the factors related to implant health like gums and bone health are controlled.

The writer is Dr. Dheeraj Kumar Koli who Associate Professor, Prosthodontics and Oral Implantology. Diplomate of World Congress of Oral Implantology, Japan Division, All India Institute of Medical Sciences New Delhi.

February 12, 2021 0 comment

Dental News Medical News Medical Organisation News

People should get quality of health services at doorstep without financial burden says Ram Madhav

by Medically Speaking Team January 1, 2021

written by Medically Speaking Team

The BJP’s Former National General Secretary Ram Madhav visited Hyderbad to attend the program conducted by the Dr K Satheesh Kumar Reddy who is member of the Dental Council of India and President of Andhra Pradesh State Dental Council.The focus of program was about the various facets of health care delivery systems India, abroad and way forward in the country, Ram Madhav stressed the importance of working together with all stakeholders to progress towards Universal Health Coverage in the country where people can access quality health services, when and where they need them, without suffering financial hardship.

The program was attended by Dr Nageswar Reddy [CMD] AIG Hospitals , Dr. Ravindranath [CMD]Global Hospitals, Dr. Gopichand [CMD]Star Hospitals, Dr. Ramesh kancharala [CMD]Rainbow hospitals, Dr Gurava Reddy [CMD]Sunshine hospitals, Dr Parthasarathy [CMD] FMS group of hospitals Dr Navneet Sagar Yashoda hospitals ,Dr Rajneesh Apollo hospitals, Dr Bhaskar Rao [CMD] GSL group of educational institutes and Dr Vamsi Krishna Reddy secretary Indian association of public health dentistry.

January 1, 2021 0 comment

Dental News

How long dentistry as a profession will survive in India?

by Medically Speaking Team September 29, 2020

written by Medically Speaking Team

By Dr Anil Chandna & Dr Anmol Kalha

The unprecedented pandemic brings with it a huge weight of fear and suffering. Now after lockdown, almost all aspects of human existence are challenged, institutions as we know them, stumble and leadership struggles to give direction to find a way through uncharted waters. Healthcare reassembles itself as all elective procedures are on hold and only OPDS are on and the entire focus is on containing and responding to the challenges of the virus.

Dentistry came to a sudden stop from 22 March 2020, as lockdown after lockdown brought the realisation that there was a serious issue at hand. All clinics were shut, institutions closed and advisories were abound high- lighting the risks of dental care, the virus being a silent passenger of aerosols, salivary glands, the mouth and the very air that was breathed in the close proximity of the patient. Since then, a slew of discussions have only served to highlight the fears and the new challenges of perhaps returning to the analog era from a rapidly advancing digital era of dentistry. The massive influx of technology, newer materials and techniques helped to build a business in India which was valued at roughly $1.36 billion, employing almost 20 lakh people directly or indirectly. 313 recognised institutions with almost 15,000 faculty and staff would add another annual dimension of Rs 1,800 crore and the stakes are high.

Before the pandemic hit and alarm bells rang regarding the lack of job opportunities, less than 50% of the graduating dentists were register- ing with dental councils for clinical practices. Rising costs of infrastructure and equipment, concentration of dental practices in metros had begun to create a negative aura to this profession, which was at one hand being grudgingly accepted as a part of mainstream healthcare. It continued to be the privilege of the wealthy and the elite as all spending was from private incomes, practically no insurance and very little in- vestment by the government to employ dentists or create opportunities in the rural sec- tor. The lack of direction even at the height of the pandemic is very obvious as no clear directions have emerged from the Ministry of Health and Family Welfare on resumption of dental practices. Advisories are there from the Dental Council and the professional associations but at the end of the day, executive directions can only be issued by the administration. A proposal to create DGDS in the Health Ministry was tabled to handle direct responsibility and regulate the dental profession but it languishes at the lack of interest and intent.

The road ahead

1. The lack of financial support will seriously impact the young dentists who entered into practice carrying a huge burden of rentals and loans. This has a huge impact as earnings dropped to zero at the beginning of the lockdown and after and the return will be slow with additional costs of PPEs, masks, trained assistants, limited appointments and the inherent fears that abound in the minds of doctors and patients both on the virulence of the virus. Add to this, the fear of quarantines and health issues in the event of a possible infection and the ripple effects begin to gather furious momentum. Is there a bail out? No one knows.

2. The practices and clinics were unregulated and not really meeting the baseline norms of asepsis and infection control before the pandemic. The first attempt to regulate was made by the government in the form of the ‘Clinical Establishments Act’ which defined the minimum requirements for both rural and urban practices. This was to be implemented in full measure and will need to be done if dentistry has to return to its position in mainstream health care.

3. Dental institutions will have to transform to provide departments of bio-safety, create adequate processes in the clinics as the fears and threats are real. Students will need training in infection control protocols, standards drill beyond the webinars and luminaries who espouse unreal wisdom. The positive aspect is that as international travel and living overseas un- veils the threats to students, there will be a return to In- dian institutions and those who transform and adapt will not only survive but flourish, after all a population of 1.3 billion people will always have oral healthcare needs.

4. Dental treatment will have to return to realism and efficiency with minimal contacts, greater reliance on diagnostics and skills rather than a massive influx of apparent technology and advertising. The whole concept of cost of care will need to be redefined. It will be about value and not just availability.

5. Investment in training of dental assistants and para- dental staff will be worth the while as the new dentistry will need a set of people with skills in infection control and assisting. This could open up an entire new field for dental institutions with excess capacity as it is and certificate courses would be very much in demand.

6. Investment in manufacture of dental materials and equipment with an export focus is very much a possibility. As global supply chains are suspended, China-centric manufacture will shift and could go in favour of intrinsic manufacture and marketing. If we are the pharmacy to the world, so could it be for dental materials and equipment.

7.We are in the midst of a population shift from urban to rural. It’s time for the government and private players to look at dental setups in rural India.

The virus is here and while there is a hushed silence, it has not solved all the issues of oral health. The world is rebooting and so should dentistry in India. There may be a lull but all is not lost. It may be a slow re- turn but return we will; after all, India has shown tenacity and resilience in the face of all adversity. Dental Council of India is putting all efforts under the Health Ministry for better outcomes.

Dr Anil Chandna is the executive member of Dental Council of India and Dr Anmol Kalha is a senior dentist.

September 29, 2020 0 comment