DT News - Pakistan - Focus on paediatric dentistry in Pakistan still low

Dr. Tayaba Naim Khan

Sat. 31 May 2014

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Pakistan is a young country with over half of its population under the age of 24 years. Around 34% of the total Pakistani population is from 0-14 years of age. The need to provide paediatric dental services is therefore very important. Sadly though there are very few devoted and specialist paediatric surgeons in Pakistan.

Some of these names include Dr, Sobia Zafar, Professor Dr. Noeen Arshad and Dr. Arham Nawaz Chohan. Khan, Mahmud and Rahman in their research found that dental surgeons show a statistical difference in their preference for adopting paediatric dentistry as their field of choice over others dentistry specializations. Until 2013, there was no comprehensive Pediatric Dentistry Fellowship program nor related faculty in Pakistan teaching pediatric dentistry as a separate subject. This subject in dental curricula is made part of conservative and restorative dentistry, giving it less importance and significance as it deserves. The question is why is there lesser interest in developing pediatric dentistry specialization programs in Pakistan and where is the role of PMDC in all this?

On the policy making side, the lack of interest in developing dental act, dental policy or national dental strategic framework have all led to creation of a disorganized dental fraternity as we see now. There is no five year plan available of how the dental industry of Pakistan will develop. There is currently no need analysis, no predictions and no training programs designed to inculcate the growing demands of dental surgeons per region according to the population dynamics. The lack of national oral disease prevention health strategy is another contributing factor in creation of mismatched human resource in dentistry. However, these issues have been prevalent for quite some time now, and will continue to do so given the current lack of leadership direction in PMDC. The disinterest of dental surgeons is also another contributor to the current crises.

One cited reason for lack of interest among dental surgeons in pursuing the field is the lack of good training programs in Pediatrics Dentistry in Pakistan. This not only means the lack of course format, but also lack of teaching and training facility and facilitators and mentors for the process. With the partnership of government, PMDC and current Pakistani pediatric dentists, the problem can be resolved.

Another cited reason is the reduced monetary compensation and perception that the dental surgeon will be considered as only a pediatric surgeon not capable to handle procedures of adult dentition. This in turn puts the preference towards adult dentistry where incentives such as orthodontic treatments and implant dentistry can bring more revenue than pediatric dental care alone. Still another reason can be reluctance to handle anxious patients which is a hallmark in a pediatric dental surgery.

Again, the dental clinics in Pakistan are mostly focused on adult dentistry with very few having pediatric dental chair setups. One exception to the rule is the first specialized child health facility at Islamabad, the Integrated Health Services providing pediatric dental services.

The impact is sobering. According to a research conducted among 300 children of a private school, almost half of the participants did not have a positive attitude towards the role of dentist in maintaining their oral health. Dental floss was a very remote concept, with only 11% of children knowing what dental floss is and how to use it. The mean DMFT of 1.27 is again another indication that poor oral health practices were in play, leading to higher DMFT scores. This indicates that the absence of a comprehensive pediatric dental care policy in the country can lead to worsening statistics. Note that these statistics were taken from a private school, where children are considered to receive more care, attention and economic support. The same statistics will be worse for children belonging to lower economic strata.

All these factors however point to one single outcome, which is reducing quality of oral care among children. As dental surgeons, do we really feel the responsibility towards taking care of the future generations? The answer, based on these statistics is a grim no.