21st century is characterised by the information age with exponential growth of knowledge in all technology fields including medicine. In this regard, the expanding field of medicine was expected to shun all the redundant ways of acquiring, practising and preserving knowledge. However, we see a slow transformation in the developing countries which still do not adapt to the rapid international developments in the field of medicine. In Pakistan, dentistry is one such field where this difference is significant and pronounced when it comes to the adaptation and use of international best practices. Here, the professional approach is rather primitive and relies on outdated teaching methodologies and technologies. This non-innovative approach is followed in a lot of dental colleges.
This is not a good model for incubation of ideas especially those germinating in the young minds. We religiously follow the obsolete teaching methodologies with poor supporting infrastructure leading to unnecessary burden on the students. Our dental student feels encaged in self shells but is at par with the international university standards. Howbeit it requires a lot of extra energy, hard work and dedication to get there. Even though these problems exist, our system is still generating one of the best professionals. The mettle and reasoning skills of the emergent professionals is considered second to none. We have managed to show our talent on international platforms. We still endeavour to bring forth future leaders in our limited resources and in our outdated system.
In order for Pakistan to be recognized among the leading attraction for dental education, dental curricula has to be shaped to ‘Problem based curricula’. The revised curricula will integrate critical thinking skills in the undergraduates. ‘Tele-conferencing’, ‘Tele-medicine’, ‘Computer-assisted Learning’ and ‘Exchange Programs’ might bridge the yawning gap between the two education systems. It is a need of time to amalgamate different intellects and give them a chance to express themselves. The talent in Pakistani students is enormous and is blessed with intelligence and the requisite tools of hard work. We just need to steer it in the right direction by using right methodologies.
Statistics of Total Number of Recognized Dental Colleges in Pakistan:
Not only dental education system is old fashioned, but the Oral health care delivery system seems to have some voids too. The challenges it has to face are of a different nature. Dentistry here does not demand sophisticated methods to deal with the problems of public health but to find the most cost effective method. Despite this, the health care professionals are not in reach of a common citizen because dental care is a luxury to those who can afford. A common man with Rs. 10,000 income and a family to support cannot be blamed if he is unable to afford a Rs. 3000 crown to save his tooth. Another challenge is the attitude of general public towards seeking dental help because it seems to shift frames. In Pakistan, a patient would only seek ‘dental assistance’ when in dire need; like excruciating pain after tooth decay or the need to have some prosthesis for the lost teeth. For them, routine dental visits are a waste of time and money and most of all, are considered ‘useless’. Moreover, Sixty-two percent (62%) of the rural population is oblivious to this need as well due to non-existent oral health care delivery systems in those areas. If we analyze the dentist-to-patient ratio in Pakistan, then we would know that for 12895 patients, there is only ONE dentist available. (Dentists = 14594, Population= 188.2 million). The manpower to tackle the oral health issues is not up to the mark. Despite limited resources, both human and material, we still are trying to combat these issues.
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One contributor to this attitude is lack of awareness among the masses regarding oral diseases and importance of maintaining oral hygiene. We, as dentists, know the simple answer to prevent this medley of diseases; “Tooth brushing twice a day” but majority is unaware of the “importance” of this simple practice. The government health sector, health organizations, practitioners and even dental students are trying to cultivate this habit in masses by focusing primarily on preventive strategies. It is a positive change in our health policies that has riveted the attention to downstream approach and has involved multiple sectors to work coherently.
Another new challenge for our health care system is the ‘exponential increase in the cases of Oral cancers of different pathologies’ over a past few years. A two-pronged way can be employed to tackle this rising issue; either by conducting awareness programs to stop its emergence by educating the public about causative agents or by diagnosis of these cancers at early stage through different screening programs. Both these approaches have been integrated but there is a need for more outreach programs and to formulate more resilient health care policies by involving multiple sectors. There should be a vigorous culture of research so that new markers, new medicines and new ways to diagnose and treat the cancer can be discovered. ‘Oral Cancer’ is our regional problem and we have to deal with it ourselves. If we delay it now, we would be accumulating problems which might become impossible to deal with in the near future.
Despite these problems which depict bleak picture of dentistry, we have array of hope; many organizations are working tirelessly to take dentistry to a new level. One such example is Pak Dental Community, a non-profit organization which is trying to bring about a change in the way we see dentistry here. It is directing the services through its outreach programs to those areas of society where dental care fails to reach. It has currently launched 37 successful programs in 6 cities. It is also bringing a healthy culture of synergizing the efforts of dental youth by giving them multiple opportunities and giving them a platform where they can bring a positive change. Along with this, it is inculcating a culture of research and also conducts up-to-date workshops at a reduced cost to facilitate greater dissemination of knowledge. Not only this, we have PDA (Pakistan Dental Association), which is constantly working on continuing educational programs, scientific seminars, educational conferences and symposiums. These organizations are also conducting international conferences and are promoting our talent by sending delegations on international seminars. Recently, Liaquat University Medical Health Sciences (LUMHS) had arranged a conference with the theme “Exploring Dental Education, Paradigm Shift in Pakistan” which focused on resolving the issues encountered in dental curriculum. State-of-the-art laboratories have been launched recently in some institutions which has shown us the silver lining. We hope, one day, we can claim the level of dentistry in Pakistan to be tantamount to international standards. With this rapid progress, we can claim that the time is nigh.
This article is intended, on one hand, to invite the dental community in Pakistan to discuss these issues so that we can devise pragmatic solutions and on the other, to attract international intellectual participation. We might be lacking resources, but progressive policies and an emancipated manpower could gradually bring about this change. These deficiencies must be raised at international platforms, and through global intellectual participation, there is a likelihood that the discussion of these issues will lead to practical solutions.
Reference for Statistics: www.pmdc.org.pk
Author: Affaf Fatima