Dental manpower

CONTENTS
Introduction
Effect of oral health on general health
Levels of health care
Existing health infrastructure
National health expenditure
Oral Disease burden in India
2

Dental health services- WHO Classification
Oral health care system in India
Dental work force in India
Dentist
Dental Auxiliaries
3

Role of dental Auxiliary
Challenges to oral health work force in India
Recommendation
Conclusion
Previous year questions
References
4

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.
5

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.
8

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.
9

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
10

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…
11

EFFECT OF ORAL HEALTH ON
GENERAL HEALTH12

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.
13

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.
14

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.
15

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
16

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.
17

ORAL HEALTH CARE SYSTEM IN INDIA
Oral 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
18

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
19

4. Indigenous systems organizations
a. Ayurveda
b. Sidda
c. Unani
d. Homeopathy
5. Voluntary organizations
a. NGOs
b. State IDAs
c. Colgate palmolive
d. Rotary clubs
e. Local authorities, etc.
6. National oral health programmes
20

1. Dentists
2. Dental Auxiliaries
22

DENTIST
A dentist is a person licensed to practice
dentistry under the law of the appropriate
state, province, territory or nation.
23

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.
24

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.
25

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.
26

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.
27

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
28

Nair dental college (Bombay) and The Calcutta
college.
Presently, there are 309 dental colleges in India.
29

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.)
30

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.)
31

Dental auxiliary is generic term for all persons who
assist the dentists in training patients.
33

WHO 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.
34

CLASSIFICATION OF DENTALAUXILIARIES:
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.
35

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
36

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.
37

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.
38

REVISED CLASSIFICATION
Slack GL, Burt BA (1981)
NON OPERATING AUXILIARIES
Dental surgery assistant
Dental secretary/ receptionist
Dental laboratory technician
Dental health educator
OPERATING AUXILIARIES
School dental nurse
Dental therapist
Dental hygienist
Expanded function dental auxiliaries
39

FUNCTIONS OF DENTALAUXILIARIES
40
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

Non – Operating Auxiliary.
 Dental surgery assistant
 Dental secretary / receptionist
 Dental laboratory technician
 Dental health educator
41

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.
42

HISTORY OF DENTALASSISSTANT:
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".
43

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.
44

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.
45

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.
46

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.
47

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)
48

The candidates are expected to have had a
secondary education and a formal course of
training of one year’s duration is required.
Curriculum
49
• The importance of ethical
behavior
• Principles and methods of
sterilization
• Preparation of filling and
impression materials

RESULTS TO BE EXPECTED WITH THE
HELP OF DENTALASSISTANT
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.
51

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.
52

DENTAL SECRETARY /
RECEPTIONIST:
This is a person who assists the dentist with his
secretarial work and patient reception duties.
53

54
DENTAL 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.

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.
55

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)
56

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.
57
(Auxiliary Dental Personnel. World health Organization.
Technical report series. No. 163)

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.
58

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.
59

 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.
60

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.
61

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.
62

 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.
63

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.)
64

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".
65

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.)
66

Denturists 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.
67

DENTAL 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.
68

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.
69

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.
70

OPERATING AUXILIARY
School dental nurse
Dental therapist
Dental hygienist
Expanded function dental ancillaries
71

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.
72

 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.
73

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

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.
76

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.
77

• 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
78

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)
79

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.
80

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.
81

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.
82

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.
83

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..
84

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
86

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.
87

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.
88

 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)
89

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)
90

TRAINING 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.
91

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.
92

Topical application of
medicaments
Study of the main chemical
substances
Dental health education
methods and materials
Oral prophylaxis
Most common diseases of
the oral cavity
Brushing technique
Instruction of the patient at
the chair
93

EXPANDED 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.
94

The personnel could be trained to perform the
desired services within considerably shorter
periods of training than required for dental
practitioners.
95

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”.
96

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.)
97

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.
98

Frontier 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.
99

1n 1981, one week training program was
conducted in Alaskan communities.
10
0

NEW TYPES OF DENTAL
AUXILIARIES
Dental licentiate
Dental aides
10
1

 NEW TYPES OF DENTALAUXILIARIES
 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
10
2

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
10
3

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.
10
4

DENTALAIDE
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.
10
5

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 .

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.
10
7

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
10
8

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.12063
Dental 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.
136

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