Standard of Dentistry In Pakistan

Standard of Dentistry In Pakistan

A lot effort and hard work has been poured into bringing dentistry where it is in Pakistan now, and I can’t thank you all enough for that. Despite limited resources, we have made a lot of progress and managed to uplift our field and if we are to really take it to the next level, we need to change our approach as new times have different requirements.

When I moved back to Pakistan, I acknowledged the earnest efforts the dentists have made for the future of dentistry: the increasing number of dental institutes, the fresh graduates working hard to be competent, the changing trends and more focus towards specializations, both local and foreign. The dedication of teachers towards the betterment of dentistry is commendable and it’s amazing to see that there are some well-establish and renowned dentists here in Pakistan. All of this serves as motivation for us to join hands and bring boom in dentistry.

In the past, people used landlines and wrote letters for communication whereas now they use smartphones and internet. They have the world in their hands. These same people are our consumers. They use portals like Google to search and gain knowledge regarding everything, even for dental treatment. Our consumers are more health and quality conscious. They know about international standards and they want the same high quality treatment here in Pakistan.

With time we have to evolve, the world is changing and we need to keep pace with it. If we don’t, then we won’t matter anymore. We can either go up or down, we can’t just stay where we are. We have to adapt to the new era. All of us, even the well-established dentists, need to acknowledge and take responsibility, and I am sure many of you are already doing it on your own, but if we put in collective effort and work together, then we can provide a platform for our young dentists to learn the quality of work that is necessary.

It is said when we point a finger out to blame, three point back at us. We can’t control the external factors, but we can control our way of dealing with the situation and how we set things up. I see 80% crown work failing due to open margins and overhangs. I see 60% root canals underfilled or not at all filled with periapical lesions. We can all have failures but acceptable level is only 5%. Some dentists are still using PFMs for smile change and do all restorative work without first establishing gum health. Using alginate for impressions and take not taking x-rays before cementation is a common practice. All of this is a lack on our part and nothing will change unless we realise our opportunities and acknowledge them, only then we can take necessary steps to overcome our challenges. Let’s stop looking at the half glass empty and look at half glass full. We should focus on the opportunities and possibilities with which we can increase our clientage and not look at the economy and financial statuses. I have always given example of cosmetic centers and gyms which were non-existent 10 years back whereas now they are thriving. The kind of procedures people are getting done here in Pakistan amazes me and they pay hefty amounts for them. The consumers don’t hold back in beautifying themselves when it comes to their looks, so why stop at the mouth? We, as a dental community, should work together and provide our consumers the quality of work that they deserve, no matter what the price tag is. When you create value for yourselves, only then people will value you and your work. Our world is evolving and with changing times there are new pathways to explore. So look at the remaining half glass full and try to fill it up.  Steve Jobs, Bill Gates, Jack Ma and so many others didn’t have much to work with but their faith and belief in themselves.

We all make plans and set goals but instead of doing what is required to get to the finish line, we end up doing things which take us away from our goals. I will give an example of a few cricketers. I think Umar Akmal was the most talented player Pakistan produced in 2000s. He had raw talent but his emotional instability and ego didn’t let him grow as a world class Batsman and now, he is not even mentioned. Asif was as good as McGrath but his greed ruined his career. Salman Butt had a really bright future but one bad decision killed it. It was entirely their own fault; they didn’t need any enemy or competitor to kick them out. We need to work on not only our skills but also to create an environment for our consumers in which they feel comfortable getting their routine checkup and necessary dental treatment done. Needless to say, there are some amazing dentists doing great work here in Pakistan, yet we cannot ignore all the substandard work being done. It doesn’t matter who is responsible for it; what matters is that it reflects on all of us and there is enough bad work being done which has caused the public to be skeptical of our quality and cross contamination standards resulting in their lack of trust in us.

I had a road side accident in 1991 due to which I suffered from bicondylar fracture and also lost a couple of teeth. It was the most painful and horrifying experience to get IMF, as the dentist was rough in handling and didn’t care if I was in excruciating pain. I had to go back to the dentist due to fractured teeth or else I would have never gone back after that experience. I joined BBC program and went to the best Prosthodontist to get a bridge. I had no temporary and while waiting for the permanent, I ended up losing abutments in 6 years’ time. One of the teeth had an endo done which was incomplete and when I was in USA, I had to go through extensive jaw surgery to get cyst removed and ended up losing so much more bone that implants wasn’t a possibility. I had a class 2 filling done and one night during my bench test to get my license in California, I woke up with excruciating pain and on dental checkup found out there was a big overhang that caused root decay and that tooth had to be extracted. So, if I lost 3 teeth after poor restorative work while I was part of the dental community and had the best help, I ended up wondering why did I not let them rotten on their own. Why does a patient have to pay so much money for a treatment knowing it will fail eventually?

I think it’s high time that as dental community we stop blaming lack of education and commitment or even financial freedom on part of patients and took some responsibility of not exploring the true potential dentistry has in Pakistan. We don’t need everyone to do certain things but there are always enough people who can. I am here to help and my efforts are for public and dentistry and not to benefit myself. Of course it will help all of us, including myself. So I invite each of our dental community colleagues to take a pause and look inside and identify what are the reasons as to why we are struggling and why patients and general public are afraid and reluctant to get the necessary dental treatment done. Let’s put ourselves in patients’ shoes and see what their concerns are. Once we acknowledge where we lack and put in efforts to improve those areas, only then will we be innovative and our horizon of possibilities will increase. This will not only make our pool of clientage bigger, it will also help us in bringing boom in dentistry. This will change things around and everyone will benefit. This will help make dentistry prosper and make our nation healthier as we will provide them the type of care they truly deserve.

Everyone is skeptical of change at first; they ridicule new ideas but then they ridicule the ones who don’t join in time. Change is inevitable; we can either fight it and slow it down or be a part of it and make it happen faster. There are abundant possibilities and opportunities out there but we must have the courage and desire to seize them, whatever it takes.