(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)
THERE are inequalities in the prevalence and treatment of oral diseases.
For the poor and marginalized, public hospitals are the preferred choice because they are affordable.
Unfortunately, in most middle-income and low-income countries, there are more private dental institutions and hospitals have dominated substantially, and are predominantly located in urban areas.
‘’A judicious balance between private and public dental teaching hospitals would be mandatory not only to provide oral health care to low-income families and marginalized populations but also to bring equity to student enrolment from various socioeconomic backgrounds,’’ says an article published in The Lancet medical journal.
The article is authored by Dr. Gargi S. Sarode and Dr. Sachin C. Sarode of the Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, in Pune, Maharashtra, India.
They believe that a better strategy would be to start new dental public teaching hospitals in rural areas and minimize the number of new private hospitals in urban areas.
‘’This strategy will address the major issue of inequalities in providing oral health created because of the higher dentist population in urban than rural areas,’’ the article observes. ‘’However, governments need to be firm on their policy decisions without succumbing to the pressure from private sector giants in dental education.’’
Needs-based workforce planning can address inequities in availability and access to oral health care resulting from the current oral health-care framework that is dentist-centered, writes Dr. Habib Benzian in the same December issue of The Lancet.
Dr. Benzian is with the Department of Epidemiology and Health Promotion, World Health Organization (WHO) Collaborating Center for Quality Improvement and Evidence-based Dentistry, College of Dentistry, New York University.
‘’This planning will not only entail changes to the way oral health professionals are trained and where they practice, but also how they collaborate and interface effectively with other health professionals within a patient-centered, culturally competent health-care system,’’ Dr. Benzian writes.
Producing better oral health-care coverage for the millions currently with little access will only be possible through innovative models, he says.
Dental-medical integration in education and care is one aspect. There is a much wider and broader efforts involving an array of oral and general health professionals, as well as non-health professionals, that will be needed.
‘’Many countries have a rapidly expanding private dental education sector driven by business interests, requiring stronger governmental regulation and coordination,’’ Dr. Benzian says.
The current similarity of dental curricula across the globe, built on high-income country models, is part of the problem as to why oral health care does not meet population needs, he says.
‘’Traditional role models, outdated curricula, vested professional interests, and rigid laws regulating dental practice stand in the way of progress,’’ Dr. Benzian writes.
He points to the WHO draft of the global oral health strategy. The draft addresses the need for new oral health workforce models based on “a public health approach to oral health [that] strives to provide the maximum oral health benefit for the largest number of people by targeting the most prevalent and/or severe oral diseases and conditions.”
This vision, together with rigorous and novel foral health workforce planning and training, will be part of the solution to the global burden of untreated oral disease, Dr. Benzian states.
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Dr. Joseph D. Lim is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; and Honorary Life Member of the Thai Association of Dental Implantology. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com/PN
