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 Table of Contents  
SHORT COMMUNICATION
Year : 2019  |  Volume : 6  |  Issue : 4  |  Page : 102-103

Dentist's destiny in disquieting oral cancers: An Indian scenario


Consultant Oral Pathologist and Dental Surgeon, Paulson Multispeciality Dental Clinic, Kochi, Kerala, India

Date of Submission21-Nov-2019
Date of Acceptance11-Dec-2019
Date of Web Publication12-Feb-2020

Correspondence Address:
Rajalakshmi Geetha
B1 Yasoram Sreyas, Opp Family Medicals Vennala High School Road, Vennala, Kochi, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdrr.jdrr_72_19

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  Abstract 


Oral cancer is a foremost problem in India where it ranks among the top three types of cancer in the country and is considered an epidemic in recent centuries. Oral cancer is the second most common group of malignancies in males and ranks in the fourth position in females in India. Oral cancers are usually preceded by clinically evident potentially malignant disorders, which can be recognized through oral screening. Early diagnosis and proper management can avert the cancerous potential of the lesion. Although oral cancer rates are alarming, existing situation of dentist in India is devastating. A number of credentials are available in medical literature highlighting the oral cancer rates and problems of dentists in India, but still not much critical steps are taken by the government to improve both situations. Moreover, the oral cavity can reflect and unravel many of the human body's internal ambiguity; in developing country like India, most people do not tend to set the same significance on dental health as they do on their medical health.

Keywords: Cancerous, oral cancer, potentially malignant disorders


How to cite this article:
Geetha R. Dentist's destiny in disquieting oral cancers: An Indian scenario. J Dent Res Rev 2019;6:102-3

How to cite this URL:
Geetha R. Dentist's destiny in disquieting oral cancers: An Indian scenario. J Dent Res Rev [serial online] 2019 [cited 2020 Feb 24];6:102-3. Available from: http://www.jdrr.org/text.asp?2019/6/4/102/278222




  Introduction Top


Cancer is a Greek word Karkinos meaning crab, denoting how carcinoma extends its claws like crab into adjacent tissues. Oral cancer is the third most common malignancy in India. Oral squamous cell carcinoma (OSCC) is the most common malignancy to affect the human oral cavity.[1],[2],[3] The prognosis of OSCC is poor due to its diagnosis at advanced stages. Despite the recent encroachment in the diagnosis and management of OSCC, the mortality rate remains high.[3] Oral cavity is prone to a myriad of changes with advancing age as well as a result of the environmental and lifestyle-related factors.[2] Oral cancers can arise from preexisting oral mucosal lesions or as de novo.[2] If the precursor lesion is discovered, diagnosed, and monitored for malignant progression, it increases survival rates and decreases the morbidity associated with the treatment of oral cancer.[4] Diligent and careful examination of the mouth and oral structures can reveal potentially malignant oral mucosal lesions.[5] It has been well established by researchers that virtually all oral cancers are preceded by visible clinical changes in oral mucosa usually in the form of white or red patches. Prevention and early detection of such potentially malignant disorders have the prospective of not only decreasing the incidence but also improving the survival of those who develop oral cancer.[2],[4]

There may be many reasons for the augment in oral cancer incidence, but a timely intervention and management helps in reducing mortality. Dental graduates can contribute much in preventing and managing of these oral lesions. Above and beyond dentists can contribute much in creating awareness among the public about oral cancers and importance of oral screening to the public. Dejectedly, the role of dentist in public health is far beyond and the least in primary health interventions. This not only creates a bunch of jobless dental graduates but also affects the socioeconomic health status of our country.

The dental profession was considered as one of the dignified professions. The graduate degree of dentistry (Bachelor of Dental Surgery) requires years of meticulous efforts and dedication.[6] Even after such scrupulous efforts, the situation of dentist in India is pathetic. If this situation continues, it will lead to a pessimistic effect on the veracity of the dental profession, and a skilled workforce will go in futile. The oral health status of the nation has been improved from previous years, but this improvement is not alike throughout the country. The improvements in oral health of the metropolitan population are better when compared with their rural counterparts. Thus, there is a significant disparity in oral health status in India. As per the WHO, the provision of oral healthcare services in rural parts of India is below the standard.[6],[7],[8] This privileged deliberation of dentists in the metropolitan areas may lead to competition, thus resulting in a number of social and behavioral issues among dentists, such as involvement in unprincipled and unethical practices. Thus, mental and physical health of the dentists also affected.[8] The discrepancy between the demand and the supply of dental professionals persists. The number of vacancies for dental professionals in government sectors is also very less. Records show that only 5% graduated dentists are working in the government sector,[6] and the rest are occupied underneath private practitioners[9],[10] and are underpaid. To date, no one has set an advisory committee nor fixed a basic pay scale for a dentist. Many dentists resort to setting their own clinics. However, opening a private setup requires a strong investment.[9] The cost of equipment and the vicinity of clinics need sound financial support. Even after such financial restraint, the private practice is not easy due to drenched market and rivalry.

It is a necessity to control over the disparity among the demand–supply dental workforce as oversupply may lead only to higher redundancy rates.

Increasing job opening in rural areas will attract dental graduates, and thus, the deliberation of dental graduates in the urban areas will diverge to underserved areas. The Government of Indian States should plan to formulate new placement for dental graduates in government hospitals and at the primary health centers.[7] Oral health programs should be planned to provide dental health education to increase oral health awareness, especially among the rural population. The inadequacy in primary oral healthcare services is also tinted in universal health coverage report of the Planning Commission of India, which may affect the India's goal to have universal health coverage.


  Conclusion Top


The dental graduates and postgraduates are in a dangerous condition, and many have migrated to other countries for their subsistence. Although overlooked, oral cavity is an important diagnostic area not just because it contains derivatives of all of the primary germinal layers but includes tissues not demonstrable anywhere else in the body. Apart from oral cancers, it also has a role in diagnosing a number of systemic and psychiatric diseases too. In the growing Indian healthcare industry, owing to demand quality healthcare, dentist and oral health also need to be considered with paramount importance. Although all of these factors cannot be eliminated immediately, the DCI and the government should take steps to retain the interest of dental graduates within the dental stream. By improving the socioeconomic status of dentist, the socioeconomic health status of our country also can be improved.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sridharan G. Epidemiology, control and prevention of tobacco induced oral mucosal lesions in India. Indian J Cancer 2014;51:80-5.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Williams HK. Molecular pathogenesis of oral squamous carcinoma. Mol Pathol 2000;53:165-72.  Back to cited text no. 2
    
3.
Ragezi, Sciubba, Jordan RK. Oral Pathology. 5th ed. Elseviar: Sunders; 2008. p. 73-106.  Back to cited text no. 3
    
4.
Caldeira PC, Aberue MH, Carmo MA. Binary system of grading oral epithelial dysplasia: Evidence of a bearing to the scores of an immuno histochemical study. J Oral Pathol Med 2012;41:452-3.  Back to cited text no. 4
    
5.
Barnes L, Everson, Reichart P, Sidransky D, editors. WHO Classification of Tumors: Pathology and Genetics of Head and Tumors. Lyon: ARC Press; 2005.  Back to cited text no. 5
    
6.
McCullough MJ, Prasad G, Farah CS. Oral mucosal malignancy and potentially malignant lesions: An update on the epidemiology, risk factors, diagnosis and management. Aust Dent J 2010;55 Suppl 1:61-5.  Back to cited text no. 6
    
7.
Yadav S, Rawal G. The current status of dental graduates in India. Pan Afr Med J 2016;23:22.  Back to cited text no. 7
    
8.
Jaiswal AK, Srinivas P, Suresh S. Dental manpower in India: Changing trends since 1920. Int Dent J 2014;64:213-8.  Back to cited text no. 8
    
9.
Dagli N, Dagli R. Increasing unemployment among Indian dental graduates – High time to control dental manpower. J Int Oral Health 2015;7:i-ii.  Back to cited text no. 9
    
10.
Mathur MR, Singh A, Watt R. Addressing inequalities in oral health in India: Need for skill mix in the dental workforce. J Family Med Prim Care 2015;4:200-2.  Back to cited text no. 10
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