Registered with the Registrar of Newspapers for India under R.N.I 53640/91
Vol. XXXIII No. 8, August 1-15, 2023
A recent Times of India article reported that Councillor Nethaji U. Ganesan, the GCC Councilor of Ward 38 in Tondiarpet, raised an alert regarding the paucity of dental treatment facilities available to the public. The solitary dental clinic in his area could not meet the needs of the populace, he said. “GCC has 140 UPHCs (Urban Primary Health Centre) but only 16 dental clinics. Nowadays, people go to hospitals for dental issues in large numbers. There should be dental clinics with trained doctors across the city. This will help the poor save thousands of rupees,” pointed out the Councillor.
According to a health official who spoke to The Hindu on the subject, only one dentist is available per zone as sanctioned by the National Urban Health Mission. 40 polyclinics that offer dental services are reportedly established in UPHCs in areas such as Mugalivakkam, Thoraipakkam, Shenoy Nagar, Virugambakkam and Saidapet. However, these are said to largely operate during night shifts and that too, on a rotational basis. The days on which dental services are offered tend to vary, making accessibility harder for patients. Mayor R. Priya’s response to the Councillor’s concern was positive. She said that a feasibility study will be conducted soon to expand dental service offerings in public health centres. According to the TOI’s report of the meeting, the administration plans to initially embed 9 a.m. to 5 p.m. dental clinics into existing UPHCs.
This is a good move for the city and one long overdue. India’s report card in oral health is poor, to say the least – oral disorders are prevalent amongst the population and widespread tobacco usage has only exacerbated the problem over time. Dental caries (tooth decay), periodontal disease and oral cancer are major public health concerns. According to a Livemint report published a few years back, the Ministry of Health and Family Welfare estimates that 60 per cent of the population is affected by dental caries – among school children, this number shoots to 70 per cent – while 85 per cent have periodontal disease.
Oral care plays an important part in determining the quality of social and professional life that a person enjoys. For instance, oral health has a significant impact on employability. In fact, welfare programs in many Western countries ensure that access to dental care is included as part of their efforts to build economic independence among the homeless and underprivileged. Studies also show that poor oral hygiene is linked to heart disease, diabetes and pregnancy complications. Unfortunately, the findings from the National Oral Health Policy 2018 suggest that oral healthcare is either severely inaccessible or simply not given due importance – only 12.4 per cent of adults in the country have ever got their oral cavity examined by a dentist.
There are several reasons why oral healthcare is inaccessible. For one, the treatment tends to be expensive. As Councillor Ganesan notes, the average cost of a tooth extraction is Rs. 2,000 at private clinics while that of a tooth filling is Rs. 5,000 – these are sums that will eat away a significant part of the common man’s household budget. While this problem has been addressed by TN’s excellent Chief Minister’s Comprehensive Health Insurance Scheme – which does cover outpatient dental care unlike most health policies – there is certainly room for public health centres to offer quality oral health services at more affordable rates. The second – and trickier – problem is that of unequal distribution of oral health professionals and facilities, which is the issue that the GCC will address by expanding care centres. It is possible that future phases will involve bigger plans. TOI reports that Dr. K. Kolandasamy, the former Director of Public Health, recommends setting up an advanced dental hospital each in North, South and Central Chennai. “This should have an MDS doctor, on temporary appointment, to do surgeries, tooth implants and braces,” he says, adding that the Corporation could also consider setting up labs to prepare dentures and screen for oral cancers.
While tackling the accessibility to dental treatment, it would be worthwhile for the administration to also consider steps to create awareness on the importance of oral health and encourage preventive care among the public. For instance, take lifestyle changes in diets. The consumption of sugar-rich foods and beverages has gone up in the past few decades while traditional, fibre-rich home meals have seen a dip – a contributing factor, doctors say, to the prevalence of dental caries among children. The expansion of dental clinics in the city’s public health centres would be served well with a public interest campaign to promote oral health in families, through messages targeted at households, schools and workplaces.