Improving oral health in India using mobile dental vans

Jeremy Booth, Dental Tribune International

Mon. 13 November 2023

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WARDHA, India: Health authorities in India face several obstacles in the efficient delivery of dental care, including a dentist-to-population ratio that is far below that recommended by the World Health Organization. The subcontinent’s vast rural population have inequitable access to dental care, and a review compiled by researchers at Sharad Pawar Dental College and Hospital in Wardha in Maharashtra state says that mobile dental vans (MDVs) could help to improve the oral health of those living in underserved areas.

According to the review, India faces significant challenges in dental care, besides having a dentist-to-population ratio of 1:30,000. Many Indians live in rural areas, but the majority of the country’s dental practitioners are based in major cities. Economic factors also play a significant role, as the cost of dental treatments often discourages visits, particularly among lower socio-economic groups, leading to exacerbated dental conditions and thus higher costs for care. Rural areas also lack healthcare resources and other resources necessary for oral hygiene, such as water, resulting in lower standards of dental care and poorer oral health compared with urban areas. Transportation barriers further complicate access, especially in isolated communities, where inadequate public transport and challenging terrain limit access to dental services.

Various sections and compartments in a mobile dental van: (A) registration area; (B) sink area; (C) area for compressor; (D) patient waiting area; (E) area for dental chair; (F) generator and driving area. (Image: Dr Ali John Hussain/Sharad Pawar Dental College and Hospital in Wardha)

The authors of the review found that MDVs could reduce or eliminate a number of the barriers, primarily by facilitating mobile, low-cost oral care in areas with underserved populations and poor access. “MDVs can be a catalyst in eliminating rural–urban inequality in terms of dental care,” they wrote, adding that “rural communities, people belonging to lower socio-economic classes, children, the homeless, and migrant populations can also benefit immensely from the correct utilisation of these vehicles”.

The review reported that MDVs are utilised by universities in India to provide training opportunities to dental interns and postgraduate students, visiting rural areas and treatment camps and aiming to improve community health and provide oral health education. Dental teams working in the MDVs deliver various treatments and procedures and provide screening services for oral and systemic disease. However, “no Indian governing body maintains data regarding the quantity and quality of MDVs in the country,” co-author Dr Ali John Hussain told Dental Tribune International.

Although MDVs were found to have a greater impact than a single independent dental practitioner, they also had disadvantages and limitations, such as high cost and complexity of maintenance and limitations in the treatment that can be provided.

Dr Hussain said: “MDVs have their limitations; for example, it cannot be expected that the treatment of a complex procedure like excision of the lesion in a patient with carcinoma be done in such a place. Some procedures require a completely sterile environment, and some procedures require large and bulky equipment, which cannot be carried in a vehicle. Also, many procedures require a multidisciplinary approach, so fitting a group of specialists in a small space would be a problem too.” Dr Hussain said that some of these limitations can be overcome, but that some patients treated in MDVs did have to travel for procedures of greater complexity.

Asked who would stand to benefit most from greater use of MDVs in India, Dr Hussain commented that those living at either of the two extremes of the economic spectrum stood to benefit most. He said: “It is a fact that the majority of Indians live in rural areas and many people in these areas cannot afford proper healthcare. [However], running an MDV is a pricey affair, and if a hospital in an urban area is providing that service, then it will charge a high fee for it to recoup the costs and eventually make a profit. Hence wealthy patients can also make use of this, as they will not have to travel to the hospital for simple procedures.”

The review, titled “Overcoming barriers to dental care in India by the use of mobile dental vans”, was published online on 27 October 2023 in the Cureus Journal of Medical Science.