Despite having one of the world’s largest dental workforces, India lacks preventive dental care systems. Lt Gen (Dr) Vimal Arora calls for urgent policy reform to make oral health a public priority.
The dominant approach to dental care in India — “drill, fill, and bill” — is reactive, not preventive. (Source: freepik)
India — the world’s fourth-largest economy by nominal GDP and home to over 1.46 billion people — still treats Oral Health as an afterthought. When nearly 85% of Indians suffer from dental problems, yet less than 24% seek regular dental care, it reflects a deep gap in awareness towards this aspect of overall health. This contradiction sits uneasily in a nation poised to become a global superpower. As India aspires to lead the world economically and demographically, it must also demonstrate leadership in health priorities — especially Oral Health, which remains neglected, misunderstood, and most importantly unrepresented.
The dominant approach to dental care in India — “drill, fill, and bill” — is reactive, not preventive. It encourages treatment only when pain occurs, reinforcing a mindset that sidelines Oral Health from routine care. This philosophy has been internalized not only by the public but also by policy frameworks, which continue to ignore early intervention models that could save lives and reduce disease burden.
Paradoxically, India is not short on dental manpower. With over 300+ dental colleges producing 35,000 graduates annually, the country has one of the largest trained dental workforces in the world. But instead of being deployed to educate, screen, and prevent, most of this talent is consumed by private, curative care. The failure isn’t of infrastructure — it’s of vision.
The consequences of this neglect are starkest in India’s Oral Cancer statistics. The country has one of the highest incidences of Oral Cancer globally, accounting for 30–40% of all cancers diagnosed in India. Even more troubling is the rising number of young patients. Studies reveal that 7–8% of Oral Cancers now occur in individuals under the age of 40, driven largely by the early and widespread use of tobacco, gutka, and areca nuts, particularly in rural and semi-urban populations.
India prides itself on having the world’s largest youth population — nearly half the population is under 25. Yet, without proactive measures, this demographic dividend risks turning into a health burden. In schools and colleges, there are virtually no structured programs for oral screenings, anti-tobacco education, or fluoride interventions. What could be easily detected and prevented in early stages is left to fester — until it’s too late.
The dental crisis is even more pronounced when viewed through the lens of access. While urban India enjoys a dentist-to-population ratio of 1:10,000, rural areas — where two-thirds of the population resides — often face ratios as poor as 1:200,000. Shockingly, 80% of India’s dentists serve just 20% of its people, concentrated in urban pockets.
This inequity is compounded by inadequate infrastructure. Most primary health centers (PHCs) in rural areas don’t even have a basic dental chair, let alone a trained dentist. Mobile dental units are rare. School dental check-ups are infrequent and unstandardized. The result: a population that has little or no access to even basic dental care — not because of a lack of professionals, but because of a failure in public health distribution.
At the governance level, the issue is even more structural. The Directorate General of Health Services (DGHS) does not have a Director General of Dental Services — a position that has existed in the Indian Armed Forces for over two decades, where oral health is treated with the seriousness it deserves.
Likewise, NITI Aayog — India’s apex policy think tank — has no dental representative, and must aim to include the country’s leading oral health professionals who can contribute to national healthcare strategy. While proposals have been floated in the past — including training dentists as general physicians — the potential of dentists as preventive care specialists has never been fully acknowledged in mainstream health policy.
The National Dental Council (NDC), while responsible for regulating education, has not led any significant national preventive program. Its mandate needs to expand — from simply accrediting colleges to shaping national Oral Health outcomes.
If India is serious about protecting its youth and fulfilling its health potential, here’s what must happen next:
Appoint Dental Leadership in Governance
Establish posts like DG Dental Services in civilian health structures. Ensure dentists are part of NITI Aayog’s health panels and state-level public health planning.
Equip PHCs with dental setups and link dental screenings to programs like Ayushman Bharat and National Health Mission. Prioritize school-based dental care and Oral hygiene awareness campaigns.
Launch nationwide campaigns that promote brushing habits, fluoride toothpaste use, regular check-ups, and tobacco cessation. The systemic link between Oral and general health — including diabetes and heart disease — should be emphasized in every communication.
Make community dentistry and prevention part of the licensing and curriculum reforms. Encourage rural internships and community service as part of professional pathways.
India is not short of dentists. It is short of direction, policy, and political will. Oral diseases — whether cavities or cancer — are largely preventable. But prevention requires investment, leadership, and vision.
The world’s largest youth population deserves a system that catches disease before it spreads, and educates before it extracts. For a country on the brink of global influence, Oral Health is no longer optional. It’s foundational.
It’s time for India to move beyond the drill — and make preventive dental care a true public health priority.
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