Prakriti Kandwal
The National Dental Commission Bill, 2023 was introduced in Lok Sabha on July 24, 2023, and passed on July 28, 2023 subsequently it was passed in Rajya Sabha on August 8, 2023. The act finally received the assent of the President on 11th August 2023. The act regulates the profession of dentistry in India, provides quality and affordable dental education and to make high-quality oral healthcare accessible.
Background of Dentistry in India
This profession in India is facing multiple challenges with regard to education, practice and employment. India has the second-highest number of dentists in the world; 3 lakh are registered with the Dental Council of India (DCI). Although India has more than the recommended dentist-to-population ratio ie. WHO recommends a dentist-to-population ratio of 1:7500. The dentist-to-population ratio of India, which was 1:300,000 in the 1960s, now stands at 1:10,000.
The problem lies in the distribution of dentists, access to oral healthcare, and lack of public institutions amongst others. There is a shortage of government colleges with only around 60 registered government colleges as a result, there is an increase in the number of private colleges. Privatisation of education has raised questions on standardisation of education, fee hikes, quality of education, accessibility of dental education. The National Dental Commission Act proposes setting up a Commission to oversee the integrated development of education and maintenance of the standards of delivery of services.
Composition of the Dental Bill
The bill revokes the Dentists Act, of 1948 and proposes to set up (i) the National Dental Commission, (ii) the Dental Advisory Council and (iii) three autonomous Boards for regulating education and standards of dentistry.
The National Dental Commission would comprise 33 members with a chairperson, 8 Ex-officio members and 24 part-time members appointed by the central government on the recommendation of a Search-cum-Selection Committee. Search-cum-selection committee will comprise the cabinet secretary, three experts, one member and the secretary to the government of India in charge of the Ministry of Health and Family Welfare as a convener. The centre holds the power to remove from office the Chairperson or any other member in situations such as abuse of power, conviction of an offence, or declared incompetent or physically and mentally incapable.
The Council shall be constituted by the central government. The main functions of the council include raising concerns in front of the commission in shaping the overall agenda, policy and action relating to dental training and education. The Council will be chaired by the Chairperson of the Commission. Ex-officio members of the Commission will also be ex-officio members of this Council.
The Act will empower three distinct Autonomous Boards: the Undergraduate and Postgraduate Dental Education Board, the Dental Assessment and Rating Board (DARB), and the Ethics and Dental Registration Board (EDRB). These boards will carry out specific assigned functions, contributing to a comprehensive regulatory framework.
Functions
The National Dental Commission’s functions include
- Laying down policies and regulations for the governance of education, examination and training.
- Promote the adoption of additional degrees or diplomas, in higher education, including the development of soft skills for the advancement of the career of the dentists.
- Ensuring admission to undergraduate dental courses through the National Eligibility cum Entrance Test under the National Medical Commission Act 2019
- Assess the requirements of oral healthcare including human resources for dental health, career progression of dentists and dental auxiliaries and healthcare infrastructure.
- Ensuring admission to postgraduate courses through the National Exit Test (NExT-Dental)
- Promote preventative dental care services
- Ensuring coordination among the autonomous board
- lay down policies and codes to ensure observance of professional ethics in the dental profession and to promote ethical conduct during the provision of care by dentists
- Frame guidelines for determination of fees and all other charges in respect of fifty per cent of seats in private dental institutions and deemed to be universities which are governed under the provisions of this act
Impact
The act provides a hopeful future for the Indian Dentistry system with introduction of high end technology in dentistry practices to allocation of resources to people across the national demography. One of the goals of the bill is to bring the regulatory structure of the dentistry education profession up to par with international norms. If implemented properly the act would be a reformative step in improving Dentistry in India along with providing oral assistance overall the country.
Emerging Issues
Accessibility– The act overlooks the most important problem with Indian Dentistry- that of accessibility, increasing the number of dentists alone does not ensure the accessibility of oral care to the general public. Proper allocation of professionals is important to raise awareness about oral care in India.
Concentration of dentists in urban areas– There is also a drastic difference between the urban-rural distribution of dentists, there are no geospatial provisions made to make oral care available in rural areas. Although systemic infrastructure deficiencies prevent proper screening and dental care to prevent these diseases, socio-cultural factors like inadequate or improper use of fluoride products and a lack of knowledge about oral health and hygiene also contribute to oral diseases in rural India. In rural PHCs, where the majority (68.8%) of the Indian population lives, there are no positions for surgeons, as was mentioned in a previous discussion, and there are no plans for oral health care, including preventive care.
Concentration of power– the power is largely concentrated in the hands of the centre from electing the commissioner to overlooking the functions of the autonomous body, this creates a hegemony of power of the centre.
Way Forward
Oral healthcare is highly neglected in India, even though the majority of the population suffers from oral issues. According to the World Health Organization (WHO), over 95% of adults in India have dental caries, and over 50% of adults have periodontal disease. It is important to raise awareness in the public and make it accessible among people. The development of infrastructure would only play a limited role in the same.
References
The Ministry of Law and Justice, New Delhi, 11th August, 2023
https://prsindia.org/files/bills_acts/bills_parliament/2023/National_Dental_Commission_Act,_2023.pdf
The National Dental Commission Bill, 2023
https://prsindia.org/billtrack/the-national-dental-commission-bill-2023
https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1946875
Sonali Randhawa, Indian Dentistry Is in Crisis – the New Dental Commission Bill Should Step Up, 10th February 2021
Abhinav Singh and Bharathi M. Purohit, Addressing oral health disparities, inequity in access and workforce issues in a developing country, 7 December 2020
https://www.sciencedirect.com/science/article/pii/S0020653920336728#bib17
Prakriti Kandwal is a research intern at IMPRI.
Acknowledgement: The author would like to thank Mansi Garg and Tanu Paliwal for their kind comments and suggestions to improve the article
Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organisation.
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