While India ranks 1st in oral cancer, dentists are switching careers to make ends meet

India accounts for a large number of oral cancer cases in the world, but the country is faced with a dearth of doctors specialising in oral health, especially in rural areas.

In Karnataka, every year at least 2,500 graduate in BDS from the 36 dental colleges in the state. But the number of dentists registered with the Karnataka State Dental Council is just 30,000 - a low number considering the number of students who graduate in dental science in the state. This is because many who pursue dentistry switch streams in search of better jobs or pay.   

Unlike other branches of medicine, dentistry has become an individual pursuit, with students having to bear the cost of setting up clinics and funding equipment.

Dr Debashis Banerjee, executive member of the Dental Council of India (DCI), said a majority of graduates are left to their own after graduation. “The profession is oriented like that, towards self employment. In an unprecedented decision, for example, Bihar decided to employ 600 dentists in primary health centres,” he said.

Dr Rajkumar S Alle, president of the Karnataka State Dental Council, “Of the 30,000 dentists registered with the council, only 25,000 practise in Karnataka,” he said. Most dentistry graduates are women. He adds that three to four years ago, there were even vacant BDS seats in Karnataka.

Many BDS graduates switch to a different course due to the low pay. Dr Lavya N, who completed her BDS from a college in Dharwad in 2010, is at present pursuing a post graduate diploma in hospital management from the Indian Institute of Health Management and Research (IIHMR).

“Dentistry is vertical. It has a set number of specialisations. It takes time to settle down after a Masters in Dental Surgery (MDS). The equipment is costly and private practice pays peanuts. You are essentially getting back what you invested. There is no break- even. I joined IIHMR because it had a promising placement record,” she said. The move to health management courses seems to be catching up, with IIHMR receiving 15 BDS graduates in 2016, compared to three in 2014.

Mohammed Sanjeev, a first-year student of MDS, is specialising in conservative dentistry. A student of Yenepoya University in Mangaluru, Sanjeev hopes to practise abroad after two years. “Despite finishing a five-year BDS programme and a three-year MDS programme, one can’t hope to earn a decent salary. Dentistry graduates are paid Rs 25,000 to Rs 30,000 per month. MDS students are paid Rs 50,000 to Rs 55,000 per month,” he said.

To set up a private clinic, Sanjeev would require at least Rs 12 lakh to Rs 15 lakh. Though he may be able to gather financial support, he says, “Not everyone is fortunate enough to do that.”

The quality of dental students graduating every year is another concern. Dr Charles Carlton, a BDS graduate from Salem, has left dentistry and is currently studying in a Bengaluru college. “The number of dental colleges have to be reduced and only the best students should be allowed to specialise, because most don’t know what they are doing. Also, women are paid lesser than men in many clinics,” he said.

Students have compared the situation to the engineering boom. “There was a craze for engineering courses. Now, it has lost its value. The same goes for dentistry. Hospitals and clinics are saturated, there’s room for no more graduates,” said Carlton.

Dr Achuth Baliga, consultant oral surgeon and implantologist at Manipal Hospital, said BDS graduates need training after graduation. “I had a modest beginning. I worked at a taluk hospital. I bought second-hand equipment and upgraded it. Training and skill are the most important factors,” he said, imploring the government to think before allowing new dental colleges to be set up in the state. “Dental colleges can’t be opened like arts and science colleges. Authorities need to look at demand and supply. Also, no one is setting up clinics in rural areas,” he said.

Most dentists and students feel the rural market has largely been left untapped because setting up clinics and living in rural areas is difficult and also residents in rural areas may not be able to afford the facilities at a modern dental clinic.

(New Indian Express)