History of the Dental Council of India
The Dentists Act 1948 (XVI of 1948) stands as an important land mark in the History of Dental Profession and Dental Education in India. The Act came into force with effect from 29th March 1948 and the Dental Council of India was accordingly constituted on 12th April 1949.
Before giving the details of the history of the Dental Council of India and the important role it has played in the growth and development of dental education and dental health in India, one feels to trace the history of the dental science in our country, and which is contained in the following chapter.
A peep into the past
A peep into the past will tell that in ancient times India was probably one of the most advanced countries in dental health service in the world. In the old Ayurvedic literature of India, details of instruments used for extractions of human teeth could be found. One also finds classification of dental diseases. In the olden days dental diseases were classified in 28 types. The descriptions of dental caries gum diseases and other dental diseases have been given very lucidly in some of the ancient references. The lines of treatment have also been mentioned. Practice of Oral Hygiene
was included in the daily rituals. Cleaning of the tongue was included in practice of Oral Hygiene. It is during 1971-1972 that western scientists have shown the importance of cleaning of tongue in prevention against dental decay and periodontal disease.
Ancient scriptures like Vedas, Puranas, inscriptions and paintings and our ancient medical literature all prove that a systematic knowledge of preserving the natural teeth in a healthy state was known to our ancient seers. Dentistry was an integral part of medical science.
Sushruta, the ancient Indian sage, is universally acknowledged as the first dental anatomist of the world. He taught dentistry about 600 B.C., scientifically at Kashi. He and his colleagues, familiar with indigenous anaesthesia and recovery, had invented several surgical instruments. They made drugs out of various herbs known in those times and taught their disciples practical human anatomy.
After Sushruta, the Science of Dentistry is known to have been taught at the Taxilla and Nalanda Universities. At these famous seats of learning, students used to come from various parts of Asia. These famous institutions had rigorous academic discipline. Students devoted their time to master the selected field. Their performance was judged
on the basis of their progress in the course of the academic year.
Unfortunately, these universities did not survive long. The Taxilla. University was destroyed by the Huns somewhere between 450-500 A.D., and the one at Nalanda was burnt down by Bakhtyar Khilji in 1203 A.D.
During the Budhist period also the dental surgery had suffered a great setback, as the teachings of Lord Buddha prohibited dissection of the human body, and the touching of dead-body or flesh came to be considered unholy.
Later, following the days of Brahmin in supermacy, with the tightening and narrowing of religious concepts, surgeons were looked down upon. Faith-cure, charms, mantaras and quackery became popular. The art of Surgery thus gradually declined in the ancient India mostly because of the aversion of the Brahmans, who had the monopoly of teaching the various sciences in those days, to animal food and to the sacrificial offerings which were too common in the pre-Budhistic period. This aversion made them shrink from touching the carcasses necessary for anatomical demonstrations. They also shrank from coming in contact with blood, pus, and other matter, which cannot be avoided in performing surgical operations. Surgery being neglected by the priestly caste, passed into the hands of the lower classes, whose practice was purely empirical.
The Mughal period also remained a period of darkness for scientific dental surgery. Vaids and Hakims, without much surgical knowledge, continued to be popular. Though Surgery continued to languish, Indian Medical Science showed some signs of revival during the time of Peshwas (1751- 1818 A.D.) Some of the later works on Indian medicines, mostly compendium of larger treatises on the subject were written during this period.
It is said the English came with the preconceived notion that Indian medicine was quackery and the Indian works on the subject a repository of sheer nonsence. They established medical schools and colleges an inestimatable boon, no doubt — but looked upon the healing art of ancient India with suspicion.
It was in the early part of the 19th century that the medical education based on modern system of medicine was started by the East India Company by arranging instructions in some institutions by the then medical practitioners who came from abroad. Obviously their object was to have some helpers or medical assistants for the troops that were stationed in India, or for Government Officers.
It was however only in 1920 that a course in Dentistry was introduced for the first time as one of the subjects of study for medical students at the Calcutta Medical College. During the whole 19th century there was no development in this field.
The year 1920 will remain as a first milestone to our progress in dental education in India. The first concrete step to organize dental education as a separate branch of medical science was taken in this year when the first full-fledged autonomous dental college was founded at Calcutta by the late Padma Bhushan Dr. Rafiuddin Ahmed, the Grand Old Man of Dentistry and rightly called the Father of Dental Education in India.
Dental Institutions before the enactment of the Dentists Act 1948
The first Dental College was established at Calcutta in 1920 by Dr. R. Ahmed. The College was started with one year diploma course (L.D.Sc.) and in 1922 the duration of the course for the same was raised to two years. In 1936-37 the said College was affiliated to the State Medical Faculty of the Government of Bengal and the duration of the Courses were then further raised to four years for the diploma course of L.D.Sc. It was affiliated to the Calcutta University, only in 1953 for the Courses leading to the B.D.S. Degree. The College which was owned by Dr. R. Ahmed was handed over to the Government of West Bengal in 1949 and now after the death of Dr. R. Ahmed it has been named after him "Dr. R. Ahmed Dental College and Hospital".
In 1923 another Dental Institution by the name of Dental and Optical College/ Punjab Dental College was started at Lahore (now in Pakistan) by Dr. Satya Pal, (who later become the Speaker of the East Punjab Legislature after independence). That College remained in existence upto late forties when it was closed down because Dr. Satya Pal, for his activities in support of freedom struggle for the country, remained in jail most of the time. This College was not affiliated to any Board or University and its diploma qualifications were recognized by the Dental Council of India only in 1960.
In 1926 American Dental College, Karachi, later known as the College of Dentistry Karachi, was started by Dr. M. K. Patel at Karachi (now in Pakistan) which was first reorganised in 1931 and later in 1936, and which was closed down in 1947 in the wake of communal disturbances following partition of the country and Dr. Patel's migration to India. Its qualification of L.D.Sc. is recognised under the Dentists Act 1948 only if granted before 31st December 1936.
In 1928, a dental institution under the name of "Andhra Dental College and Hospital" was founded at Bezwada by Dr. H. M. Rao and in 1933 this Institution was re-named as American Dental College and Hospital and was located at 56 Thambu Chetty Street, Madras, where it continued to function upto 1947. But is qualifications were never recognised.
In 1932 another College called the City Dental College and Hospital was started at Calcutta and during the period 1932 to 1940 nearly 114 had qualified from this Institution. This College also granted the Licentiate (L.D.S.) qualification and the courses were said to be of two years, and the admission requirements were Matriculation. Its qualifications are recognized under the Dentists Act 1948 only if granted before 31st of March 1940 to any person who had undergone two-years' course of training in that institution, or having been previously engaged in practice as a dentist or a medical practitioner, had undergone one year's course of training in the said institution.
In 1933 Bai Yamunabai L. Nair Hospital Dental College was started with one-year course for medical licentiates and graduates; and the following year a two year course for matriculates was started. The next year it was increased to three years and still next year to four-year course leading to the diploma of L.D.Sc. The Examinations were conducted by the Nair Hospital Dental Board. In 1946, the College was taken over by the Bombay Municipal Corporation and a new building was built-to meet the requirements of the Bombay University, to which it was affiliated in 1954 for the B.D.S. Degree Course. The College is also imparting training for the Post-graduate Courses (MDS) in seven Specialities of Dentistry. Dr. V. M. Desai was the first Dean of the Nair College and the co-founders were Dr. Vero P. Desa and Dr. F. N. Vaid. This College made rapid progress under the charge of late Dr. V. M. Desai who continued as its Dean till his death in 1957.
In 1933, the De Montmorency Dental College and Hospital was inaugurated at Lahore with Dr. U. S. Malik and Dr. M. L. Watts as leading personalities on the teaching Staff. In 1936 the College started a regular Course leading to the Punjab University Degree of B D S. and Dr. C. D. Marshall Day was appointed as Dean of the College. This College was granted affiliation by the Punjab University in 1938 and a separate Faculty of Dentistry was then formed. Thus, the De Montmorency Dental College and Hospital, Lahore (now in Pakistan) has the credit of producing first degree holders in Dentistry who were awarded B.D.S. degree by the then Punjab University in the undivided India before partition of the country. Not only that this was the first Dental College producing dental graduates who were awarded University Degrees but Post-graduate Courses in Dentistry (M.D.S.) also were, for the first time, granted by the De Montmorency Dental College in 1945, in Lahore. Dr. K. L. Shourie, President of the Council was amongst the first to receive M.D.S. Degree, from this College. His was the first research thesis on Dental Caries.
Graduates and Post-graduates of De Montmorency College of Dentistry formed nucelus for the advancement of the dental education during the pre-independence and post-independence era. In 1938, an institution styled and named as "Delhi Dental College and Hospital, was started in Delhi; but its qualification had not been recognised under the Dentists Act 1948, and it did not survive.
In 1951 the College of Physicians and Surgeons started F.C.P.S. in Dentistry. Earlier it was granting L.D.S., C.P.S. The first Examination for Licenciate Course in Dental Surgery (L.D.S.) was conducted by the College of Physicians and Surgeons of Bombay in December 1941. In all eight examinations were conducted from December 1941 to December 1954 and in all 16 candidates qualified.
During the earlier years, both: Nair Hospital Dental College and Sir Currimbhoy Ebrahimji Memorial Dental College, were affiliated to the College of Physicians and Surgeons Bombay.
Factors that promoted the Dentists Act 1948
Apart from the establishment of these dental institutions, other efforts were made by the Government and private bodies, like Provincial Dental Associations and the All India Dental Association. Several Committees were appointed both by the Centre and State Governments, but the most important amongst these was the "Health Survey and Development Committee" appointed by the Government of India in October 1943, under the Chairmanship of Sir Joseph Bhore, to make a broad survey of the then existing position in regard to health and make recommendations for further development of health education and profession. But before proceeding with the report and the influence it had in shaping the pattern of dental education, dental health services and regulation of the dental
profession in the country, it would be quite natural to record here some of the earlier efforts made in this direction, though not very effective, but certainly helpful, in focussing the attention towards the dire need of proper dental education and dental health services in the country.
The two Dental Journals : namely, the Indian Dental Journal founded in 1925 by Dr. R. Ahmed and the Indian Dental Review started in 1927 by Dr. M. K. Patel, had their impact in their own way. These two journals provided a good forum for discussion of the need of scientific dentistry and ethical practice. These Journals definitely created a sense of involvement amongst the then Dental Surgeons.
In 1934, the then Government of Bengal appointed a Committee called 'Dental Education and Registration Enquiry Committee', which recommended a standard curriculum and enactment of the Dentists Act. Accordingly the Bengal Dentists Act was passed in 1937 and the examinations in dentistry were held by the State Medical Faculty of Bengal.
In 1936, Dr. M. K. Patel drafted and submitted to the then Government of Sind a draft Dentists Act for the then Province of Sind (now in Pakistan). In 1937, the Bombay Presidency Dental Association also prepared a draft Dentists Act for the then Province of Bombay and in 1940 they also organised a 'Centenary Celebration of Dental Education' under the Chairmanship of Dr. S. P. Kapadia, to focus the attention of the State Government about the dental health needs of the population.
Similarly a draft legislation for the constitution of the Punjab Provincial Dental Board was also proposed by the Punjab Dental Association.
Dr. S. K. Majumdar toured practically whole of India to consolidate opinion and to secure co-operation of all concerned for the formation of the All India Dental Association. Accordingly, All India Dental Association was formed in 1946 with its Headquarters at New Delhi. Dr. R. Ahmed was elected as the first President (with Dr. S. K. Majumdar in the Chair) and Dr. N. N. Bery as the first Hony. General Secretary of the Association. Draft Dentists Act was prepared by the AIDA and circulated to its all branches for opinion. Dr. N. N. Bery, on behalf of the Association presented the draft Act to the Government of India and actively followed up the said Bill, which ultimately resulted in the Dentists Act.
As earlier stated above, the most effective instrument that brought about the real break through was the report of the Bhore Committee. This was a high-power Committee and all Shades of opinion, professions, various governmental and international agencies were represented on it. The Committee is rightly credited with bringing in a new concept and a great leap forward practically in all directions of health education and services; and one would be failing in recording the events in its correct perspective if due credit to the Dental Section Committee which consisted of such stalwarts, as Dr. C. D. Marshall Day, Dr. R. Ahmed and Dr. V. M. Desai is not given for their understanding, pragmatic thinking and farsightedness. The subsequent developments have proved beyond doubt that whatever has
been done and achieved in the field of dental education and dental health services, nothing has been outside "outlines and guidlines", suggested by these pioneers and which ultimately speeded up the "dental reform" in the country.
Surveying the then position with regard to dental education, dental health services, and dental profession, the Bhore, Committee had briefly speaking, concluded as under :-
- 1. Dentistry has unfortunately been one of the neglected subject of study in practically all Indian Universities."
- 2. Facilities for Post-graduate training in dentistry hardly exist.
- 3. Of those dental surgeons who practise in India, the vast majority treat only the wealthy. For the poor there is practically no provision at all and throughout the country dentists are employed to a very limited extent, in hospitals under State control.
- 4. Extreme shortage of adequately trained dental surgeons.
- 5. The profession of Dentistry is as yet almost totally unorganised in India and no legal provision exists for its regulation.
The Bhore Committee had gone quite deeper in the whole matter and had made a number of recommendations, notable amongst them are briefly summarised hereunder :
1. Provision be made for the three types of dental personnel :
- Dental Surgeon
- Dental Hygienist
- Dental Mechanic.
2. 25 Dental Colleges should be established with 100 admissions at each and that each College should be capable of training 100 Dental Hygienists and the required number of Dental Mechanics.
3. The Courses of instructions etc. which are pursued at all the dental colleges should be standardised.
4. Provision should be made in all Universities for the establishments of degree of Master of Dental Surgery (M.D.S.)
5. The increase in the number of dental Colleges and improvements in the training of dental surgeons and hygienists will not lead to satisfactory results unless the State itself undertakes the establishment of a comprehensive dental service to meet the urgent needs of the population. As a short-term measure to be implemented within a period of ten years the Committee had recommended the establishment of dental clinics as follows:-
- To be attached with all the then existing every 500 bed hospital at secondary unit Headquarters (139 in all)
- To be attached with every 200 bed Hospital (216 in all)
- A mobile dental organisation for every secondary unit (710 in all).
6. The legislative measures should be enacted for the dental profession and the central and provincial Dental Councils should be created and the later should be charged with the duty of recognising training institutions, qualifications and maintenance of dental registers with disciplinary regulations for the profession. It were these vital recommendations of the Bhore Committee that ultimately paved the way for the enactment of the Dentists Act 1948 and the formation of the Dental Council of India.
The Dentists Act 1948 vis-a-vis The Dental Council of India
The enactment of the Dentists Act 1948 is the turning point in the history of dental education in the country. The Act made provision 'for the regulation of the profession of dentistry and for that purpose to constitute Dental Councils.'
The then Viceroy and his cabinet gave their assent to the Dentists Bill in 1947 and thereafter the Bill was put into wider circulation for elucidating public opinion and the great debate followed. In view of the conflicting opinions, the Bill was referred to its Select Committee by the Constituent Assembly of India. The Select Committee consisted of Rajkumari Amrit Kaur, Shri M. L. Chattopadhyaya, Shri Deshbandhu Gupta, Shri L. Krishnaswami Bharati, Shri V. Subrahmanyam, Shrimati D. Durgabai, Shri P. Kundhiraman, Shri H. Imam, Shri Yashwant Rai, and Shri Ram Nara'yan Singh. The Select Committee submitted its report on 28th January 1948 and it was placed before the Constituent Assembly on 25th February 1948. Hon'ble Rajkumari Amrit Kaur, the then Union Minister of Health, while piloting the Bill said that "the principles of the Bill are noncontroversial and needs no advocacy." But the Bill was thoroughly debated for full two days and after a score of amendments put forth by the members of the Constituent Assembly, the Bill was passed on 26th February 1948 and received the assent of the President of India on 29th March 1948. In accordance with the provisions of the Act, the Dental Council of India was formedon 12th April 1949 by a special Notification issued by the Government of India.
Now, before going through the role played by the Dental Council of India for the development of dental education and the regulation of the dental profession in the country, one might like to examine the functions and duties entiusted to the Council under the various provisions of the Dentists Act 1948, as only then the correct assessment of achievements and failures could be made.
The Act provides for a Dental Council at the Centre and formation of State Dental Councils in the States and Union Territories. While the Dental Council of India at the Centre is the overall body to look after the welfare of the dental profession and for that purpose to maintain proper uniform standards of Dental Education in the country, the State Dental Councils are primarily responsible for the maintenance of registration of dentists, dental hygienists, and dental mechanics, and matters arising thereof.
For the purposes of regulating the standards of Dental Education in the country, the Dentists Act 1948 empowers the Dental Council of India to (1) inspect any dental institution imparting dental courses, such as Post-graduate Course in Dentistry (MDS), Under-graduate course in Dentistry (BDS), Dental Hygienists Courses, and Dental Mechanics Courses. The powers to appoint inspectors for this purpose are vested in the Executive Committee of the Council. Secondly, the Dental Council of India is vested with, powers to recommend to the Government of India recognition or de-recognition of both Indian and foreign dental qualifications obtained by the Indian nationals which might not be specified in any of the three Schedules appended to the Act. Thirdly, the Dental Council of India is the Examining Body for the two statutory examinations envisaged under Section 34 of the said Act. The Act further authorises the Dental Council of India to enter into negotiations with the authorities concerned abroad for settling of a scheme of reciprocity for the recognition of dental qualifications.
The Dental Council of India, with prior approval of the Central Government, is empowered to lay down Regulations and Curriculum for the various Courses in Dentistry such as M.D.S., B.D.S., Dental Hygienists, and Dental Mechanics; and to ensure uniformity and maintain standard of dental education in the country. The Dental Council of India is further empowered to lay down code of Ethics for Dental Surgeons in their professional behaviour. Over and above, the Dental Council of India is entrusted with the task of maintaining an All-India Dentists Register. This Register is to be maintained by the Dental Council of India on the basis of the State Dentists Registers and compiled in alphabetical order.
For the first five years, the Act provided that the President of the Council would be nominated by the Central Government. Accordingly, Dr. K. C. K. E. Raja, the then Director General of Health Services was the first nominated President of the Council till his retirement on 17-9-52. Lt. col.C.K. Lakshmanan who succeeded Dr. Raja as the Director General of Health Services was then nominated as the President of the Council.
Dr. R. Ahmed was the first elected President of the Council who was elected as such by the Council on 5-11-54. He was succeeded by Col. N. N. Bery, who was the Vice-President of the Council since its inception in 1949 and who was elected as the President first on 7-11-59 and later reelected on 6-8-62 and continued as such till August 1967. Col. Bery has been mainly instrumental for whatever has been accomplished by the Council during these years.
The President of the Council Dr. K. L. Shourie was first elected on 28-8-67 and again re-elected on 24-11-69. His electionas President of the Council proved to be yet another turning point in the history of the Council as it provided an opportunity to take stock of the situation in an independent way. For the first five years, the Secretaries of Council were appointed by the Central Government they were : (1) Dr. H. G. D. Mathur (2) Shree B. S. Raizada and (3) Shree B. D. Sharma. Thereafter, the Council appointed (4) Capt. S. Bratt in 1956 – who retired in 1971 and was succeeded by the Secretary of the Council, (5) Shri D. N. Chauhan, who had earlier jioned the Council as Assistant Secretaty since 1962.
While inaugurating the first meeting of the Council on 14th May 1949, the late Rajkumari Arnritkaur had said- "In the proper direction and control of this training and development programme, the Dental Council of India, indeed, must play an important part." The history of the last 23 years amply shows, that the Council has faithfully carried out the wishes of its inaugurator.
Council's role in the Development of Dental Education in the country
(A) Courses :
The Dentists Act 1948 has charged the Council with the task of :
— prescribing the standard curricula for the training of dentists, dental hygienists, dental mechanics and the conditions for such training;
—prescribing standards of examinations and other requirements to be satisfied to secure for qualifications recognition under the Act;
To achieve these, the needs are :-
uniformity of curriculum standards of technical and clinical requirements, standards of examinations;
a uniform standard of entrance to various courses in dentistry;
affiliation of every dental college to an University;
Supervision over all the dental institutions to ensure that they maintain the prescribed standards;
regulation of the profession of dentistry.
Naturally, therefore, it was the first task undertaken by the Council immediately after its coming into being to look to these needs. In May 1949, a Committee consisting of Dr. U. S. Malik, Dr. R. Ahmed, Dr. M. L. Watts, Dr. G. V. Desai and Major I. M. Manchanda was appointed to lay down the minimum basic requirements and the standards of dental education and Regulations and Curricula for the B. D. S. Courses. In Feburary 1950 another Committee was appointed consisting of Major I. M. Manchanda, Dr. V. M. Desai, Dr. Rup Narain, Dr. M. L. Watts, Dr. Krishna and Dr. R. Parkash to draw courses for the training and examinations envisaged under Section 34 of the Dentists Act 1948 i. e. qualifying examinations for registration on Part "B" and for transfer from Part "B" to Part "A" of the Dentists Register.
Yet at the same time another Committee consisting of Dr. R. Krishna, Dr.U.S. Malik, Dr. G. V. Desai, Dr. M. L. Watts and Lt. Col. I. M. Manchanda was appointed to lay down courses and Regulations for the Dental Hygienists and Dental Mechanics. After mature delebrations and considerations of these reports and after consulting the State Governments and the Universities concerned, the draft Regulations and Courses for the four - years' BDS Course, two-years' Dental Mechanics training and One-Year Dental Hygienists Course, were submitted to the Government of India in the Ministry of Health, who after further consideration, and in consultation with the Director General of Health Service, approved of these Courses as required under Section 20 of the Dentists Act 1948.
These courses have since been revised by the Council from time to time, in light of the experience, scientific development and latest trends in the field of dental education. The first Committee to revise the Regulations and Courses for BDS Course was appointed in October 1957, which consisted of Dr. K. L. Shourie, Dr. H. D. Merchant, Dr. U. S. Malik, Dr. T.N. Chawal and Dr. M. G. Rao. Their report was considered by the Council in March 1962 and the revised Courses were, as usual, after consultations with the State Governments and the Universities, were approved by the Government of India in 1963. Yet another Committee consisting of Dr. T. N. Chawal, Dr. B. R. Vacher, Dr. M. S. N. Ginwalla, Dr. S. Ramachandra and Dr. R. P. Lall was appointed by the Council in 1967 to review the staffing pattern for dental college and the qualifications and experience etc., for each category of dental
teachers. The revised norms so envolved by the Committee and further modified by the Council and after usual consultations with the State Governments and the Universities have since also been approved by the Government of India under Section 20 of the Dentists Act- 1948 and are operative w.e.t. 17th September 1971.
Courses for Social Dentistry as part of BDS Courses have also been evolved. The Council is besieged with the question, of revising the entire BDS Syllabus in light of the latest trends and scientific development in the field of Dentistry and to meet the present needs of the new social order and concept.
As for the revision of Courses for Dental Hygienists and Dental Mechanics, the Council had appointed a Committee in 1968 consisting of Dr. V. Subramanian and Dr. M.G. Rao. The report of this Committee was placed before the Council in 1969 when it was referred to be examined by another broadbased Committee consisting of the Council's President, Dr. K. L. Shourie, Dr. T. N. Chawla, Dr. Y. C. Chawla and Dr. S. D. Sharma with the Co-opted member
Brig. Mulk Raj. The report of the second Committee was thoroughly discussed in the Council and after usual consultations with the State Governments and the Universities the revised Courses were submitted to Government of India. The Government's approval as required under Section 20 of the Dentists Act 1948 have since been received,
but since the changes now proposed are, major, and that the courses for Dental Hygienists have been raised to two years instead of one, the revised Courses for Dental Mechanics shall be operative form the academic session 1973-74 and that for Dental Hygienists from the academic session 1974-75.
The other courses laid down by the Council so far relate to Examinations No. I and II envisaged under Section 34 of the Dentists Act 1948 and the Certificate/ Diploma Courses in Public Health Dentistry (since dropped in view of the establishing of post-graduate degree Courses in Public Health Dentistry).
The partition of the country had left only three dental colleges in India, namely, the Nair Hospital Dental College, Bombay, Sir. C. E. M. Dental College, Bombay and the Calcutta Dental College, Calcutta. Of these only Sir C. E. M. Dental College of Bombay was affiliated to the University of Bombay for the 4 years' BDS Course and at the remaining two colleges only licentiate qualifications of LDSc/LDS were awarded.
With the laying down of the four-years' BDS Courses as the minimum basic standard for dental education in the country, the Licentiate Courses were abolished.
Although the Universities are independent and autonomous Bodies, but since the recommendatory power to recognise or de-recognise qualifications in dentistry are vested in the Dental Council of India, it has exercised a very healthy influence on the growth and development of dental education in the country. The Council had in addition
to the Regulations and Courses, also laid down the detailed standard requirements in respect of Staff, Accommodation, Equipment etc. for the different Courses being run at all the Dental Institutions in the country.
The first new Dental College after independence and the enactment of the Dentists Act 1948 was statetd at Lucknow in 1949, followed by Madras in 1953, at Patiala in 1956, at Bangalore, Trivandrum and Hyderabad in 1963, at Ahmedabad in 1963, at Manipal in 1966 and at Nagpur in 1968.
Plan-wise, - the number of dental colleges in existence before the 1st Five Year Plan period was four. Three dental colleges were opened during the 1st Five Year Plan, four during the 2nd Five Year Plan and two during the 3rd Plan. During the two years after the 3rd Plan and commencement of 4th Five Year Plan another two dental colleges were opened. No dental college was opened during the 4th Five Year Plan period.
There were 15 Dental Colleges, all affiliated to various Universities, for a regular four-years' BDS Degree Course. Dental Faculties have also been formed at the Universities of Bombay, Calcutta and Gujarat. Out of those 15 Dental Colleges, 12 are financed and run by Syate Governments, and as regards the remaining three, (1) the Nair Hospital Dental College, Bombay is financed and administratively controled by the Bombay Municipal Corporation; (2) the Dental College Lucknow is financed and administered by the Luckow University and (3) the Dental College at Manipal is run by the Kasturba Medical College Trust and the Academy of General Education, Manipal - which is the only Dental College located in th rural area.
Facilities for the training of Dental Hygienists Courses have been instituted at the armed Forces Medical College, Poona (since 1963), Dental College, Trivandrum (since 1963) Government Dental College, Bombay (since 1967) Dental wing, Madras Medical College, Madras (since 1967) Punjab Government Dental College, Amritsar (since 1967 and now discontinued) and the Dental College, Bangalore (since 1971).
Training facilities for Dental Mechanics are available at the Government Dental College, Bombay, and the Dental College at Lucknow, Trivandrum, Madras and Bangalore and at the Armed Forces for Class I and II Dental Technicians Courses.
Examinations both for Dental Hygienists and Dental Mechanics are conducted by the Board of Examiners as approved each time by the Dental Council of India.
In 1967, taking note of the lack of employment avenues and the growing rate of unemployment amongst dental surgeons, the Dental Council of India had recommended that no new dental college should be established and the number of admissions at the existing dental colleges should not be increased. That is why no new colleges have since been opened and the plans for the proposed Dental Colleges at Delhi, Varanasi, Pondichery, Jaipur, Srinagar and Orissa have to be kept pending.
One of the most important functions of the Council is to arrange inspections of the teaching facilities and examinations after they are established. These inspections are primarily for the purposes of considering recognition of the dental qualifications under the Dentists Act. 1948. The institutions even after their qualifications are recognized can be and have been inspected to ascertain its standard so that the teaching facilities as also the standard of examinations are maintained at a satisfactory level. This way, the Council has carried out inspections, atleast twice and in many cases more than that, of all the dental colleges and Postgraduate Departments as also the Dental
Hygienists and Dental Mechanics Courses. The Inspectors are required to report in details amongst other things, about the existing facilities in respect of Staff, Accommodation, Building, Equipment, Library, Teaching Aids, Museum and Hostel facilities and the standard of examinations. These reports are very thoroughly considered by the Council and the deficiencies are brought to the notice of the authorities concerned i. e. the concerned University and the State Government and the necessary action is taken whenever required in specific cases.
It is these inspections which have been the main factor in establishing the authority of the Dental Council of India and thereby of immense help in raising the standards of dental education in the country.
Post-graduate Education in Dentistry
The last decade has seen a considerable change in the status of Post-graduate dental education in the country. Before that, as observed by the Bhore Commitee, "facilities for Post-graduate education (in dentistry) hardly existed". As eariler stated the regular Master's Degree in Dentistry (MDS) was awarded by the College of De Monomorency College of Dentistry at Lahore in the forties and it were the Post-graduates of this College that formed the nucleus for the advancement of dental education during the pre-independence and the post-independence era. At the time of partition of the Country (1947) there was no institution imparting the MDS Courses in the divided India.
The Bhore Committee proposed that in view of the acute shortage of trained teachers all graduates in dentistry should be encouraged to proceed for a higher degree and provisions should be made in all the Universities to establish the MDS Courses, as in that way only can a well - trained cadre of Teachers of Dentistry be gradually built up in India. As a temporary measure, the Bhore Committee further suggested that 'dental graduates should be encouraged to proceed overseas to study the modern trends of dental education and to pursue courses of training in special subjects in order to get professional appointments on return to India. However in this procedure the snag was that quite a few candidates of return preferred to go into private practice and opted to work in the teaching institutions/ hospitals only in an Honorary or Part-time capacity. Further, it was not possible to send a large number of candidates to other countries because obtaining admissions for Postgraduate training was not easy, and the cost of the Post-garduate education in the advanced countries was very high.
Taking note of all these factors and the importance of initiating Post – graduate education in dentistry in India, the Dental C.,uncil of India in 1959 laid down the Regulations and detailed Syllabus for the Master's degree Courses and made the Central Government agree to bear as much as 75% of the total cost of the same. The Universities were also pursuaded to establish the Post- graduate Courses.
The nine specialities for post-graduate education in dentistry as prescribed by the Council are:-
- Prosthetic Dentistry
- Oral Surgery
- Operative Dentistry
- Oral Diagriosis and Dental Radiology
- Dental Pathology and Bacteriology
- Pedodontia and Preventive Dentistry
- Public Health Dentistry
*M.D.S. Courses in Pedodontia and Preventive Dentistry and Public Health. Dentistry were laid down in 1963 and 1971 respectively.
Courses for Social Dentistry as part of BDS Courses have also been evolved. The Council is besieged with the question, of revising the entire BDS Syllabus in light of the latest trends and scientific development in the field of Dentistry and to meet the present needs of the new social order and concept.
In 1959, for the first time Post-graduate Departments were established in the first seven specialities as referred to above at the two Dental Colleges at Bombay, viz; Govt. Dental College and Hospital, Bombay and the Nair Hospital Dental College, Bombay. Col. N. N. Bery (as the then President of the Council), Dr. V. M. Desai (the then Dean of the Nair Hospital Dental College) and Dr. K. L Shourie (the then Dean of the Government Dental College, Bombay), have played a significant role in establishing these M.D.S. Courses at Bombay.
The Post-graduate Courses in the various specialities of dentistry were also available at the Dental Colleges at Lucknow, Amritsar, Trivandrum, Bangalore, Madras, Ahmedabad and Manipal. Even the registration for Doctorate Courses like Ph.D. and D.Sc. in Dentistry is now open for which the Mysore University has taken a lead. The need of the hour is the establishment of a dental teaching research Institute duly equipped and properly manned on the lines of the All India Institute of Medical Sciences, New Delhi, for the purpose of extensive and intensive research and training programme for research workers and teachers.
(B) Refresher Courses :
Earlier more than fifty percent of practicing dentists are those who have had no formal training in recognized dental teaching institutions. To bring them up to-date both in practice and theory of dentistry the refresher courses is the way out. These courses would have posted the dentists with the changing trend in dentistry and recent advances in the subjects. But so far, no head way has taken place in the past towards this. During the year 1966-67 a sum of Rs. 75,000 was allocated by the Central Government for arranging Refresher Courses for general medical practitioners and an equal sum was also ear-marked subsequently, but no funds were provided for Refresher Courses for Dentists.
(c) Dental Research :
Though, the Council had played a significant role in the sphere of post-graduate education in dentistry, it had not so far been able to give due recognition and push to Dental Research in the country. The Indian Dental Association and the Commercial Houses such as Gibbs, Lever Bros. etc. had made grants for the small projects. But it was the formation of the Dental Research Advisory Committee of the Indian Council of Medical Research which had revolutionised the field of dental research by extending it far and wide through-out the country, by actively organising and sanctioning various dental research projects at the various dental colleges in the country. PL 480 Funds need special mention as most of the big research projects in dentistry were financed by it.
The Dental Council of India has however compiled a compendium of all the Research papers published in the country, which is available in the Library of the Dental Council of India.
Registration of Dentists
The Bhore Committee had observed that :
"Dentistry as a science can make little progress in the country until it is upheld by suitable legislation directed to compulsory registration and prohibition of practice by unregistered persons."
Under the provisions of the Dentists Act 1948 the State Dental Councils are primarily responsible for the maintenance of the Registers of Dentists, Dental Hygienists and Dental Mechanics and matters arising thereof. The Dental Council of India, is entrusted with the task of maintaining an All India Dentists, Register. This Register is compiled in alphabetical order by the Dental Council of India on the basis of the State Dentists Registers obtained from time to time from the various State Dental Councils. The first Indian Dentists Register was compiled and printed by the Dental Council of India in 1952 and since then a series of such Dentists Registers and their Supplements have been published, always keeping the record uptodate in respect of all the dentists.
Once the Dentists Act 1948 is enforced in any State/Union Territory, no dentists can evade registration, as the practice of dentistry without registration is an offence and punishable under the Dentists Act 1948. A dentists has not only to seek registration once, but has to have his name renewed every year on payment of the prescribed fees, laid down by the concerned State Dental Councils for the purpose, failing which his name is struck from the State Dentists Register. The name so struck can however be restored on the State Dentists Register upon payment of the penalty fee alongwith the renewal fee. If a dentist after his registration obtains any additional recognized dental qualification, that he can get it added against his name in the State Dentists Register upon payment of the prescribed fees. One-fourth share of all such fees realised by the respective State Dental Councils all over India is payable by them to the Dental Council of India, the Central Body.
The task of preparing the Registers for Dental Hygienists and Dental Mechanics are also vested in the State Dental Councils. So far, such Registers of Dental Hygienists and Dental Mechanics have been preparea in Punjab, Uttar Pradesh, Andhra Pradesh, Madras, Mysore, Kerala and Delhi. The number of registered Dental Hygienists and Dental Mechanics in these States/Union Territory is 585 and 712 respectively.
Code of Ethics
Since mere registration is not enough to regulate the profession of dentistry, the Dental Council of India has also laid down, with prior approval of the Government of India, detailed 'Code of Ethics' for Dentists, which has since also been adopted by all the State Dental Councils. This 'Code' has been a great check on the unethical practice in the country, though in the absence of proper machinery to check the unethical practice, much is desired in this direction, the offences being non-cognizable.
Dental Health Services-and-Dental Manpower
In the pre-independence era the dental profession was practically not operating in India at all. It was not because that the population groups were not suffering from the dental diseases. Dental surveys carried out before independence show that 40-60 percent children were suffering from dental decay. Malocclusion was quite common amongst school children 'and oral cancer was also commonly met with. Further periodontal diseases were very common, more than 90% adults suffered from periodontal disease. There were quite a few unqualified persons in the absence of qualified persons who used to exploit the masses to the extremes. A person used to work as a cycle repairer, iron-smith and as a dentist also.
The basic objective of any dental manpower requirements should therefore be to make dental health care available, as promptly as national resources permit, to all citizens who need and want it, so that the total health of the individual and the nation are best served. The programme should be designed on the basis of well defined goals. It should identify the steps that are to be taken to meet those goals and establish a time limit for their implementation. It should also provide for periodic review and evaluation of progress that has been made in order to provide an opportunity for adjustment to meet the changing conditions and goals. The universally recognised factors which are taken into consideration for assessing dental manpower for any country are, the population and its growth rate the distribution of population — the urban and rural, the per capita income, the educational levels of the population and the incidence and prevalence of dental diseases.
Based on these factors, the available national resources, and with the knowledge of the existing stock of dental personnel and their distribution by geographical locations, a required/desired ratio of dentist to population is established. A thorough knowledge of the dental health problems — which vary from State to State — is an essential preliminary for assessing dental manpower which are further conditioned by the economic, political, and social conditions of the people.
Perhaps guided by these factors and taking into consideration the local condition prevailing in our country, the Bhore Committee (1945) while realising the need for expansion of dental services had observed that the "object of the proposed expansion of dental education is not only to provide private practitioners, but also to furnish the personnel for the State Dental Services which cater for the huge population which is completely neglected". They had therefore recommended that "our attempt for short-term dental programme should be to provide Dental Sections at all the District Hospitals and a Mobile Dental Van at all such District Hospital." The Bhore Committee was rightly of the opinion that the increase in the number of dental colleges will not lead to satisfactory results unless the State itself undertake the establishment of a comprehensive dental service to meet the urgent needs of the population.
In a joint Memorandum by the Dental Council of India and the Indian Dental Association, to the Mudaliar Committee (1956) it was recommended that at the end of the 3rd Five Year Plan, the 500 School Dental Clinics as proposed by the Dental Council of India be opened and that these should be followed by opening of more and more School and other Dental Clinics till the eventual figure of 5000 clinics are established in the country in the 20 years' period. It was impressed that "in the ultimate analysis we must plan to have a National Health Scheme where free Dental treatment is provided for the entire population of the country".
The population of the country is about 547 millions and the total number of registered dentists about 5500 on that time. The recommendations of the Bhore Committee with regard to the ratio of dentists to population were for 1 :4000.while the optimum level recommended by the Dental Council of India is 1 :30,000. To arrive at this Dental Council of India's optimum level of ratio of dentists to population India requires at least another 15,000 dentists. Actually, the total number of registered dentists is 5500 and including another 2250 unregistered dental surgeons working in the States where the registration has not taken place there would be 7,750 dentists in the country.
It is being increasingly realised that in the course of the three Five Year Plans the Dental Health Services have not been expanded. The reason for this is not far to seek. With communicable diseases accounting for a major portion of the total morbidity and mortality, the funds allocated for dental care were diverted by concerned authorities and used for these preventive programmes — while the guardians of the Dental profession and the Council remained as spectators.
During the 1st Plan a sum of Rs. 1 crore was earmarked for dental clinics, but no such clinics were opened. In the 2nd Plan it was proposed to have 324 Dental Clinics, one each at District Hospitals, but not over 70 such clinics were sanctioned. In the 3rd Plan it was proposed to establish 500 School Dental Clinics in addition to Dental Clinics at District and Tehsil Hospitals. No School Dental Clinics were opened and hardly 20 to 30 additional Dental Clinics were established at District Hospitals. There are atleast 200 Districts in the country where the Dentists-population ratio is 1 : over 1 lakh and in some 40 to 50 Districts the Dentists-population ratio is as high as 1 : over 5 to 20 lakhs.
The brief review of the existing provisions of dental care in the country makes it quite clear that only a fraction of the requirements of the people is being met. Recent investigations have shown that over 95% of our population suffers from periodental diseases and over 85 % suffers from dental caries. Of the total deaths due to cancer, over 30% of such deaths in our country are due to 'Oral Cancer'. The emphasissing position is that there is acute demand from the public for dental treatment and there is acute unemployment amongst Dental Surgeons. A questionnaire sent by the Council to those who qualified during 1967, 1968, 1969 and upto April 1970, revealed that out of 583 graduates who replied 221 (38.9%) were unemployed. The unemployment amongst fresh dental graduates is due to lack of availability of equipment and the heavy monetary investment that one has to make in establishing a private practice. It was only since 1967 that the Dental Council of India seriously took stock of the situation and launched a massive campaign for the development and improvement of the Dental Health Services and vigorously pursued the matter with the various State Governments and brought home, to some extent, the awareness for the dental health needs amongst Health Administrators both at the Centre and in the States.
The Central Council of Health and the Planning Commission while concurring with the Dental Council of India, incorporated in the 4th Five Year Plan for Health that "for the proper preservation of dental health of the Nation, it is of utmost importance that sufficient emphasis be given for starting massive dental health services in the 4th Plan period for school children and adult population."
The result, though not very satisfactory, but is quite encouraging. The total number of dental clinics in the country has since (1967) risen from 300 to about 700. The State Governments are now paying more attention to dental health needs. In Mysore 41 Dental Clinics were sanctioned and are scheduled to be established from 1972; in Uttar Pradesh 35 Dental Clinics are to be opened on a phased programme of 7 clinics per year; the Madhya Pradesh is going to open about 40 new Clinics. The Haryana Government have opened 33 Dental Clinics. In most of the States, the Mudaliar Committee's recommendations to have Dental Clinics at all the District Hospitals has been
achieved. In J & K and H. P. many more Dental Clinics have been opened at Hospitals other than District Hospitals. The funds allocated for Dental Clinics during the 4th Plan period by the various State Governments are : Bihar 15 lakhs, M. P. 15 lakhs, Mysore 27.25 lakhs, A. P. 5 lakhs, Maharashtra 2.5 lakhs, Delhi 5 lakhs, Goa 2.5 lakhs, Gujarat 10 lakhs, Tamil Nadu 11.5 lakhs. Further, the States have been requested by the Dental Council of India to
create a separate Cell to look after the Dental Services in each State, and so at the Centre.