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When Pakistan came into being back in 1947, we had
only 250 hospitals and no basic health units (BHUs)
or Rural Health Centres (RHCs) at all. There were a
total of 6500 doctors, out of which only 600 were
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dentists. Today, 68 years down the line, the situation
albeit not matching those of developed nations is
however, much better than what it was about 7
decades ago. We have about a 1000 hospitals all over
Pakistan, in addition to 5300 BHUs and about 600
RHCs. There are a total of 165,000 doctors out of
1,2 which 15000 are dentists.
The reason that I have stated these statistics is to
elicit the current oral health status of Pakistanis in
the perspective of the health care system. What we
need to understand is the fact that these 15,000
dentists are all we have to facilitate a population of
about 200 million, giving a ratio of 1 dentist for
13,000 people. Let us readjust these figures to
account for some practical issues. As per Tudor Hart's
inverse care law which elicits the inverse relationship
between the demand and supply of health needs and
health professionals, we may very well appreciate
the fact that the majority of these dentists are
practicing in the urban areas, which house only
about 30‐35% of the Pakistani population. To make
the situation worse, 62% of the dentists' population
are female, a large proportion of whom do not even
practice dentistry and those who do, generally do
not prefer to work in rural areas. So, if we were to
estimate that in the rural areas of Pakistan, 1 dentist
serves a population of 20,000, we would not be
pushing it too far.
This bleak picture of the oral health care system in
Pakistan is an actual reality. Given the extremely
limited access a Pakistani person has to oral health
care services, one would not be too optimistic
regarding the oral health of the nation. Although, we
do not have any recent nationwide statistics to elicit
the average oral health status, several studies
reporting oral health statuses of small samples of
Pakistanis show that carries and periodontal
EDITORIAL
How much do Pakistanis Care about Oral Health?
Muhammad Humza Bin Saeed
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Correspondence:
Dr. Muhammad Humza Bin Saeed
Assistant Professor, Community Dentistry
Islamic International Dental College
Riphah International University, Islamabad
E‐mail: humza.saeed@riphah.edu.pk
3‐5 diseases are quite high. Furthermore, people
usually report to the dentist only when their teeth
have become grossly carious.
Another fact that needs to be considered is that
Pakistan does not have an independent oral health
policy at the national or provincial level. There are no
vacancies for dentists on any of the health policy
making bodies. Also, there are no considerations for
oral health in any of the future health proposals. If
we take the government's 'Vision 2030' as an
example, the plan does contain a chapter on health.
However, oral health has not been taken into
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consideration at all.
All of the above mentioned indicators suggest that
oral health is not really perceived as being very
important in Pakistan, both by the government and
by the masses. In order to maintain good oral health,
it is imperative that people consider oral health to be
important for their overall general health. As former
US Surgeon General C. Everet Koop said:
“If you do not have oral health, you're simply not
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healthy”
If people do not consider oral health to be important,
the implications of such perceptions and beliefs
would be expected to be reflected on the general
health as well. Similar to general health, oral health
trends also follows a social gradient. With more than
60% of Pakistan's population belonging to the lower
socioeconomic class, the expected oral health
indicators would also not be very favorable. To add to
this situation, oral health education campaigns are
almost non‐existent across the country. Different
health care auxillaries working in the field, such as
the Lady Health Workers, are not trained in oral
health and hygiene education. Subsequently, the
motivation or education that the general public
receives regarding oral health and hygiene is through
media advertisements, which do not always provide
evidence based information.
Based on these facts, it may be deduced that the
general Public's apathy towards oral health, may be
explained mostly by the lack of government policies
to address oral health in Pakistan.
Pakistan's public health capacity to address oral
health is limited. Oral health needs to be there on the
governments' public health priority list. Dental
schools should incorporate community based oral health education in their curriculum. Oral health
education awareness programs should be planned at
a national level. As time is passing, Pakistan's
previous dental force is slowly being replaced by
younger energetic dentists who have a new zeal and
energy to work. With young dentists with a broader
vision coming up in Pakistan, the future will hopefully
hold hope for improved oral health care in Pakistan.
Muhammad Humza Bin Saeed. (2015) How much do Pakistanis Care about Oral Health?, Journal of Islamic International Medical College, Volume-10, Issue-4.
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