Same as title. An interesting article. For most of us, we may not be aware much of the Dental market. This report provides a brief understanding about the same. Hope you enjoy reading

1. Indian Journal of Dental Sciences.
June 2011 Issue:2, Vol.:3
www.ijds.in Original Article
All rights are reserved
Indian Journal
of Dental Sciences
E ISSN NO. 2231-2293
P ISSN NO. 0976-4003
¹ N. K Ahuja
Demographics & Current Scenario with ² Renu Parmar
Respect to Dentists, Dental Institutions ¹ MDS,PGDHHM
Professor and Director Post Graduate Studies,
& Dental Practices in India Dept. of Orthodontics & Dentofacial Orthopaedics
Subharti Dental College Swami Vivekanada Subharti
University Meerut, Uttar Pradesh- India
Abstract
India is the largest democracy and the second most populated country in the world. However, more than ² MDS Sr. Lecturer, Dept. of Orthodontics Subharti
Dental College Swami Vivekanada Subharti University
70% of the people of India are residing in the villages. As, far as dentists and their availability is Meerut, Uttar Pradesh- India
concerned to this huge population, the demand and supply ratio is far inadequate and insufficient. The
dentists: population ratio of India, on date is 1: 10,000. However, the reality is that; in rural India 1 dentist Address For Correspondence:
is serving over a population of 2,50,000. Thus, the real picture is not that simple as it seems. As, we are
about step into the next decade, there lies an urgent need to analyze the dental work force of the country Dr. N. K Ahuja
MDS Professor and Director Post Graduate Studies,
and to study the scope and future of dentistry in the coming years. There are still many underserved Dept. of Orthodontics & Dentofacial Orthopaedics
groups that do not have any access to oral health care. To address the complex circumstances facing Swami Vivekanada Subharti University Meerut,
our dental workforce, solutions will almost certainly involve a broad spectrum of interests that include Uttar Pradesh- India
oral health and public health care professionals, representatives from minority in¬terests, insurers and
other payers such as businesses, consumers, and most importantly, central and state legislatures.
Dental educators, including those in dental schools must work together to strengthen and build
partnerships within these communities. It is only by working together with a common goal that dental Date of Submission : 14/05/2011
education will have the means to meet the challenging diversity of oral health care needs facing our
nation and to maintain a viable and strong academic dental education system. Date of Acceptance : 20/05/2011
Key Words
Demography, Quackery, Dentist:population ratio, Dental council of India
Dental diseases are one of the most common world's most populous country by 2025,
of non-communicable diseases. Though surpassing China.1 “A peep into the past : The history of
they are rarely life threatening, they do dentistry in India”
impact the quality of life. Dental problems India is a country of diverse ethnic groups;
can cause severe pain, loss of man days & geographical character, culture, religion and The presiding deity of Bastar (The
morbidity. Thus, they are an important languages. It has 29 states and 6 union Goddess of tooth - Danteshwari) :
public health concern. According to the territories. The sex ratio at birth is – 1.05 Danteshwari is a temple in the town Bastar
World Health Organization (WHO), the male(s) / female(s). The average life of Jharkhand. It is believed that the tooth of
prevalent oral diseases are dental caries, expectancy is– 62.5 years & the literacy rate Sati fell here where this temple is located
periodontal diseases & edentulousness. is – 65.38%. today (Fig1).3
“Dental diseases are expensive to treat However, India has an astonishing
however, simple to prevent.” demographic dividend; where more than
50% of its population is below the age of 25
Demographics of India - and more than 65% below the age of 35. It is
Situated majestically in the Asian expected that, in 2020, the average age of an
subcontinent; India is the largest democracy Indian will be 29 years, compared to 37 for
& the 7th largest country in the world. It China and 48 for Japan. More than 70% of
occupies 2.4% of the world's land area & the people of India live in more than
supports over 17.4 % of the world's 5,50,000 villages, and the remainder in more
population. The demographics of India are than 200 towns and cities.
remarkably diverse. India is the second most
populous country in the world, with over The total population of India is nearly 1.147
1.147 billion people (estimate for April, billion, with 637.38 million males & 509.62 Fig 1. – Lord Shiva performing tandava with
2010), more than a sixth of the world's million females.2 the dead body of Sati, during which the tooth
population & only China has a larger of Sati had fallen at Bastar
population. India is projected to be the Demographics of Dentistry in India -
© Indian Journal of Dental Sciences. All rights are reserved 8

2. Dentistry as portrayed in the Epic of specialties of dentistry. (Dental Council of dentists in the country, the most basic oral
Mahabharata : Indis’s fig. - 2,881 / Year).5 health education & simple interventions are
Lord Krishna in Mahabharata wanted to test also not available to vast majority of
the “danaveerata” of dying Karan in the When we compare the dentist: population population and that is the misery of the
battle field of Kurukshetra. Disguised as ratio of India to that of America, the whole scenario.
Brahmin, Krishna asks for gold in donation population of America is nearly 33crores, &
& Karan proves his worth by donating his there were 108 dental colleges. However,
gold filled tooth (Fig 2). This part of the epic considering the dentists: population ratio &
indicates the existence of dentistry even to cut the no. of fresh dentists graduating
around 2500 BC, wherein defective teeth every year, the no. of dental colleges in
were restored with gold America are now reduced to 58.6 Thus,
Comparing to the ratio of dentists:
population of America, India should have
only 119 colleges against 289.Similarly
when comparing to the Chinese Population
which is the world’s highest at 1.6 billion,
there are only 160 dental colleges in China.
In that direction, if we consider the dentists:
population ratio of India, India should have
only 112 dental colleges.
Fig. 2 – Lord Krishna disguised as Brahmin
and Karan donating his gold filled tooth
The Factual period :
Sushruta, the great surgeon of ancient India;
taught dentistry scientifically at Kashi,
about 600 B.C. During that period, dentistry
flourished scientifically all over. However, Fig. 4,5 –Dental hygiene practices in rural
thereafter; for ages dentistry remained in india (Oral health is given low priority)
darkness as the Brahmins of ancient India WHO recommends, dentist to population To elaborate, the other established reasons
abhorred to touch flesh, blood & pus. Even ratio of 1:7500. Dentists-to-population ratio are as follows:
in the Mughal period, the thinking did not of India, which was 1:300,000 in the 1960’s, 1. Geographical variations
change much. However, scientific dentistry stands at 1:10,000 today. However, the 2. Uneven dentists: population ratio
was reintroduced in India in the 19th century dentists: population in the Indian Army is far 3. Poor specialist: Generalist ratio
by the Britishers. In spite of this; for long better at 1: 5,000; due to the fact that it is 4. Poor dentist: auxiliary ratio
dentistry predominantly remained in the mandatory to see every individual’s teeth 5. Low priority given to oral health
hands of unqualified & even today in some atleast once in a year in the Army. There is a
parts of the country it still remains the same. total workforce of 1,18,000 dental
practitioners in India at present, which is According to the WHO, the provision of oral
In 1924 – The 1st dental college of India was expected to swell to 2,25,000 shortly.7 health care services are very little in rural
established in Calcutta by Dr. R. Ahmed. parts of India, further complexity is lent by
In 1933 - The Nair dental college & Are really we short of dentists? the great variation that occurs across this
Hospital, Bombay, came into existence. Considering the above facts and figures, the population on social parameters such as
In 1938 – The Govt. Dental college; question arises that are we really short of income and education.
Bombay, was started and thereafter there dentists? To answer this query, one should
was no looking back. understand the distribution of dentists in Prevalence of dental caries is high &
Today we have come a long way from the India. The problem lies at the level of provision for restorative treatment is
hypothetical era to the age of scientific & distribution rather than the number of dental inadequate in most parts of the country.
evidence-based dentistry. surgeons. About 80% of dentists work in DCI’s National survey is been conducted to
major cities in India; compared to the determine the prevalence of dental diseases
Dentists, Dental institutions and Dental population where more than 70% of the in different states of India. Prevalence of
practitioners in India – Indians reside in the rural areas. Very little dental caries is 40%-80% (Very high in
There is a staggering of 289 dental schools oral health care services are provided in the Northern states 85%-90%), Periodontal
in India (Table 2 & Fig 3), producing more rural areas, however; oral healthcare conditions usually increase with age and are
than 30,000 graduates every year. [Dental seeking behavior is also very low, especially found more in rural areas. Oral cancer and
Council of Indis’s fig. - 30,570 / Year] (Table among the rural population (Fig. 5). A precancerous conditions are 3%-10%
1).4 mismatch exists between oral health (Highest being in Orissa 7% (World’s
More than 2800 postgraduate students are professionals & the population they serve.8 highest). 9
enrolled every year (Table 3) in various Even with a workforce of 1,18,000 qualified
© Indian Journal of Dental Sciences. All rights are reserved 9

3. Dental practices in India – Only 15 – 20% of people in India are able to Demand for quality healthcare at affordable
Barring aside quackery (Fig. 6), we have get dental services through national costs is the natural outcome of this
single unit dental setups to the most modern schemes. The annual per capita public development
lavish multi-chaired exotic dental clinics, health expenditure in India is no more than
including dental spas having the most Rs.200.8 Thus, reach and quality of public 3. Increasing market size -
modern equipment and gadgetries spread all health services have been below desirable The Indian Healthcare market is at about 60
over in cities and metros. standards. 80-85% of people are spending billion US$. The industry is expected to
money from their pocket. May be due to this grow to 150 billion US$ by 2017. The Indian
fact - Oral health care seeking behavior is healthcare market is one of the largest
very low in India, people rarely visit dentist services sectors, contributing 2% to the
and that too only in the event of pain. country's GDP.11
Although huge unmet treatment needs
exists; striking inequality in delivery 4. High growth in domestic market –
system, and absence of an adequate Government has invested large sums in
community-oriented prevention system is healthcare. India is among the top 5
further aggravating the lack of reach of countries that offer health services to poor in
dental facilities in rural parts of India. public sector. Subsidies are provided to the
economically poor Financial assistance
Surprisingly, only 1% of the total GDP is from nationalized banks is provided at 9% to
allocated for public healthcare moreover, 10% interest to establish private practices in
there is no specific separate allocation for rural areas.
oral health-care. In the last financial year
only 6% of the total GDP was allocated to 5. Present Dental Industry -
health-related expenditures in India, Total market for the Dental equipments and
whereas other smaller Southeast Asian materials is estimated to be around 50
countries with smaller population allocate million US$ annually. The potential size of
nearly the same amount or more for health India’s dental market is estimated to be vast.
related activities. Even Maldives is
spending 7.1% of its GDP on health-related 6. High growth in import of dental products
activities. –
Another area that is experiencing steady
The brighter side of the picture - growth is the import of dental products.
However, the brighter side of the picture India’s market for dental products is
Fig. 6 – A quack sitting with a whole bunch is reflected in - extremely dynamic, with a current estimated
of readymade dentures and another, filing 1. Growth in dental tourism - growth rate of between 25 to 30%.
the teeth of a patient in order to reduce the Quality of medical and dental treatment in
dental display metropolitan cities in India is as good as 7. Health Insurance -
anywhere else in the world & is available at After liberalization of economic policy, a
Health of a population depends on - much cheaper rates when compared to the large number of private players have entered
1. Health care delivery system western countries. The cost of comparable into the Indian market. Dental health
2. Socio-demographic profile of the dental treatment is 1/8th to 1/5th of that in insurance also, has become a part of
population western countries. The concept of dental comprehensive health insurance cover now.
a). Socio-economic status tourism is gaining significance and near
b). Literacy rate future will see a further growth in dental 8. Reduced import duty structure -
c). Health indicators eg. maternal and infant tourism. Medical, including dental tourism Government has liberalized the import
mortality rate, life expectancy etc. is expected to become a 2.2 billion US$ policy and a uniform taxation system.
industry by 2012. Tourism has increased Presently, the import duty is only 10.7% on
Principle is “Health for all”, through more than 20-fold since 2000.10 90% of the dental equipments & on the
primary health care approach, which is the remaining 10 %, it is 26%. For Consumable
foundation of rural health care system. 2. Increased health care awareness – dental products the dental import duty is a
Robust national economic growth, rising max. of 28%. The liberal polices of govt. has
family incomes, better socio-economic boosted global trading and created
The integrated network
environment, rapid growth in private sector, opportunities for international dental
Aanganwadis increasing penetration of health insurance manufacturers.
(including dental) have all made healthcare
Primary health centre a fast growing private sector and leading to 9. World bank aid to set up infrastructure -
increased health awareness. Growing Even World bank is providing financial
Community health centre awareness has brought, increasing demand assistance to develop and run hospitals &
for better healthcare facilities. Many Indians diagnostic centers in rural areas; Govt. is
District hospitals are purchasing health insurance. Healthcare also encouraging such initiatives to improve
awareness among the urban people is health care facilities.
Tertiary care centre
considerably higher than the rural people.
© Indian Journal of Dental Sciences. All rights are reserved 10

4. 10. National Rural Health Mission - dentistry is likely to increase. Thus, the Table 1. Growth in number of graduates
The government seeks to provide effective future of dentistry is bright. from Indian dental schools
healthcare to rural population throughout
the country. The Mission is an expression of References - Year Graduates
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academic dental institutions must meet
quality standards established by the Dental
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b). Encouraging dentists to establish
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to make dental treatment affordable by more
number of individuals.
The efficacy of future treatments are
difficult to predict, however the demand for
© Indian Journal of Dental Sciences. All rights are reserved 11