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LETTER TO EDITOR
Year : 2017  |  Volume : 15  |  Issue : 2  |  Page : 181-182

Inverse care law still holds for oral health care in India despite so many dental graduates: Where do we lack?


1 Department of Public Health Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
2 Department of Orthodontics and Dentofacial Orthopaedics, YMT Dental College and Hospital, Navi Mumbai, Maharashtra, India
3 Oberoi Dental and Implant Centre, Tagore Garden, New Delhi, India
4 Department of Public Health Dentistry, NIMS Dental College, Jaipur, Rajasthan, India

Date of Web Publication13-Jun-2017

Correspondence Address:
Sukhvinder Singh Oberoi
Flat No. 20, Triveni Apartments, H-Block, Vikas Puri, New Delhi - 110 018
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaphd.jiaphd_119_16

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How to cite this article:
Oberoi SS, Gautam G, Oberoi A, Yadav R. Inverse care law still holds for oral health care in India despite so many dental graduates: Where do we lack?. J Indian Assoc Public Health Dent 2017;15:181-2

How to cite this URL:
Oberoi SS, Gautam G, Oberoi A, Yadav R. Inverse care law still holds for oral health care in India despite so many dental graduates: Where do we lack?. J Indian Assoc Public Health Dent [serial online] 2017 [cited 2020 Nov 28];15:181-2. Available from: https://www.jiaphd.org/text.asp?2017/15/2/181/207908

Sir,

According to Tudor Hart, the inverse care law states that the availability of good medical care tends to vary inversely with the need for it in the population served. The force that creates and maintains the inverse care law is the operation of the market and its cultural and ideological superstructure which has permeated the thought and directed the ambitions of our profession.[1]

At present, India has the greatest number of dental colleges in the world. In addition, the dental industry and the education sector have grown tremendously during the past decades.[2] The current data on dental professionals and dental education in India show that India has 310 colleges granting degrees in dentistry (268 private and 42 public), 25,270 available student positions and approximately 14,000 students graduate annually to give a dentist to population ratio of 1:9992. Even with such a large workforce, most of the people in India do not have access to basic oral health care.[3] The dentist to population ratio is 1:10,000 in urban areas whereas it drastically falls to 1:150,000 in rural areas.[3]

Although dental care is a part of primary health care in India, dental care services are available in very few states at the primary health care level. Patients are not covered under any type of insurance and generally pay out of their pockets to get treatment from both public and private dentists. In regions where adequate dental workforce is available, yet the utilization of oral health-care services is low, thereby widening the oral health differences across the socioeconomic classes.[4] Various factors such as demographic, behavioral, socioeconomic, cultural, and epidemiological contribute to people's decision to either forgo care or seek professional assistance for dental problems.[5],[6]

One potential way of balancing the rural–urban inequality could be through integration of dentists into the primary health-care system. The primary health-care system of India has a strong network of health centers and workforce.[7] The records showed that only 5% graduated dentists are working in the government sector.[3]

The failure of the government to absorb sufficient number of graduating dentists into the primary health-care system partly resulted in mushrooming in numbers of private dental clinics. Urban polarization of private dental practitioners has made dental services entirely inaccessible and unaffordable to rural people.[8]

A wide gap is created between the actual dental needs of the population and the demand for dental care which lead to the various obstacles in utilization of dental services for rural population in India. A crisis-like situation is coming for the rural population for the deficiency of dental health-care services and dental professionals for the lack of job opportunities. An implementation of the National Oral Health Policy whose draft was prepared long back is the need of the hour.

Thus, to manage the inverse care oral health situation in India, the community health initiatives are the need of the hour. The support of the state government, policy makers, and regulatory agencies has to be directed toward developing the rural health-care system of the country for improving the oral health conditions of the rural population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Hart JT. The inverse care law. Lancet 1971;1:405-12.  Back to cited text no. 1
[PUBMED]    
2.
Elangovan S, Allareddy V, Singh F, Taneja P, Karimbux N. Indian dental education in the new millennium: Challenges and opportunities. J Dent Educ 2010;74:1011-6.  Back to cited text no. 2
[PUBMED]    
3.
Yadav S, Rawal G. The current status of dental graduates in India. Pan Afr Med J 2016;23:22.  Back to cited text no. 3
    
4.
Singh A, Purohit B. Targeting poor health: Improving oral health for the poor and the underserved. Int Aff Glob Strategy 2012;3:1-6.  Back to cited text no. 4
    
5.
Cohen LA, Bonito AJ, Eicheldinger C, Manski RJ, Macek MD, Edwards RR, et al. Behavioral and socioeconomic correlates of dental problem experience and patterns of health care-seeking. J Am Dent Assoc 2011;142:137-49.  Back to cited text no. 5
    
6.
Andersen RM. Revisiting the behavioral model and access to medical care: Does it matter? J Health Soc Behav 1995;36:1-10.  Back to cited text no. 6
    
7.
Central Bureau of Health Intelligence. National Health Profile 2012. New Delhi: Central Bureau of Health Intelligence; 2013.  Back to cited text no. 7
    
8.
Suresh S. The great divide. Rural-urban gap in oral health in India. J Dent Orofac Res 2012;8:1-6.  Back to cited text no. 8
    



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