Since gaining independence in 1947, Pakistan has made significant strides in the field of dental care delivery and education. However, the journey has been marked by challenges, gradual progress and the ongoing need for improvement to ensure that every citizen has access to quality dental care.
In the years immediately following independence, Pakistan faced numerous challenges, including a lack of infrastructure, limited healthcare facilities and a shortage of qualified dental professionals. Dental care was primarily concentrated in urban centers, with rural areas having little to no access to dental services. The focus of dental practices was largely on tooth extraction rather than preventive care, which was reflective of the limited resources and knowledge available at the time.
In Pakistan, dental education at the time of partition was limited to a single two-year dentistry course offered in Lahore at a pre-existing dental college since 1934. This program was subsequently extended to a four-year BDS degree. While dental teaching sections were established decades later at Liaquat Medical College in Hyderabad, Khyber Medical College in Peshawar and Nishtar Medical College in Multan; all these sections have been upgraded as full- fledged dental institutions. These institutions, along with a smaller dental department at Bolan Medical College in Quetta, were insufficient to meet the growing dental needs of the expanding population of the country.
More dentists were needed, and to meet this demand, more dental colleges were necessary. The public sector couldn’t cope with the situation and had to invite the private sector to help shoulder the responsibility. The private sector took this seriously and in 1991, the first-ever private sector dental college was established in Karachi.
Currently, 48 dental institutions recognized by PMDC and HEC are functioning across the country, producing around 3,000 dentists annually. These institutions have produced a growing number of dentists who are equipped with modern knowledge and skills, leading to a gradual improvement in the quality of dental care and has significantly reduced the dentist-to-population ratio of 1:156,000 to the WHO-recommended 1:7,800.
Dentistry has traditionally been viewed as a specialty field, but today, numerous clinical and non-clinical dental specialties are globally acknowledged, with international universities offering doctoral programmes in these areas.
To address this development and produce clinical specialists, educators, and researchers, various dental postgraduate programs are offered by multiple universities and the College of Physicians and Surgeons Pakistan. The postgraduate education has not only enhanced clinical competence, ensuring better patient outcomes and satisfaction but also has promoted research and academic excellence, contributing to the substantial improvement in dental science.
The adoption of modern dental technologies has been another important aspect of the progression of dental care in Pakistan. Over the years, there has been a significant shift from the rudimentary practices of the past to more sophisticated and specialized care. The introduction of digital imaging, CAD/CAM, laser dentistry, Cone Beam CT scan and implantology has greatly enhanced the diagnostic and treatment capabilities of dentists in the country.
Private dental clinics and hospitals have also proliferated, particularly in urban areas, offering advanced dental services that are at par with international standards. These advancements have not only improved the quality of care but have also increased public awareness about the importance of oral health.
Despite the advancements in dental technology and education, oral health awareness among the general population has been a persistent challenge. Historically, oral health has not been given the same level of attention as other health issues, leading to widespread issues such as dental caries, periodontal diseases, and oral cancer. However, in recent years, there has been a growing recognition of the importance of oral health in overall well-being. Public health initiatives, such as community dental camps, school-based oral health programs, and awareness campaigns, have been implemented to educate the public on the importance of maintaining good oral hygiene and seeking regular dental check-ups.
Government and non-governmental organisations have also played a role in promoting oral health through various programs aimed at improving access to dental care in underserved areas. Mobile dental units, free dental camps, and partnerships with international organisations have been instrumental in reaching marginalized populations.
Despite the progress made, existing dental care system continues to face significant hurdles. There is a stark disparity in access to dental care between urban and rural areas, with rural populations relying on unqualified practitioners or traditional remedies. The high cost of dental treatments in private clinics also limits access for low-income families.
The focus on curative rather than preventive care remains a barrier to improving oral health outcomes in the long term. There is a need for more comprehensive public health policies that integrate oral health into the broader healthcare system, emphasising preventive care, early diagnosis, and treatment.
There must be a concerted effort to address the disparities in access to care, promote preventive practices, and integrate oral health into the national health agenda. Taking these measures, Pakistan can ensure that every citizen, regardless of their socioeconomic status or geographic location, has access to quality dental care and the opportunity to maintain good oral health.
The Author is Dean Faculty of Dentistry, Baqai Medical University