Your approach to the problem is very good. Evidence based dentistry is a good thing. To follow that, we can follow on the terms of something like 'non-profit' Contract Research Organisation set-ups, providing more intense evidence and cheaper solutions, as the resources in low income and middle income countries are lesser. In this way, we can make the dental treatment more available and spread more awareness about how important is getting dental treatment in those areas. While the better resourced dentists can work on new things, which could trickle down to this level next and we can make technology more efficient and simple.

It can become a good model for growing the domains of our field.

In my opinion insurance is the best approach. In developing country public insurance with a basic coverage of services combined with commplemantary insuenace will help people to cover their treatment cost. Government can play important role in this plane to cover people who can not pay thier preimum \.

By shifting to direct approach

Many ways...

1.reduce your profit margin..charge the patient less.

2.take support from charitable clinics or govt hospitals..i often refer patients to my colleagues at nair dental or govt dental college

3. Take aponsorship from companies like colgate..they are v supportive, esp for children's treatment.

Also do only that treatment that is really required.

But then, sadly, we cannot do preventive dentistry.

As Kari Hexem said about the midlevel providers, that is a different aspect, it has been proved that it brings down the costs though, but not the morbidity of the populations. My emphasis is on more studies on the needs in the lower to middle income economies and re-invent the technology according to their resources, that is 'reverse innovation'.

Arnavaz has also come up with some good suggestions which can actually reduce the costs momentarily but sustaining these practices in the long run is not possible.

Saurabh Lall and Fariborz Bayat have provided a good suggestion too. We will have to think like economists too to build it up nicely!

The paper attached here is about the midlevel providers. Please go through this and carry on with the discussion. We might get to some conclusions like this.

http://www.jada-plus.com/content/144/1/75.full

by Public health dentistry. Meaning implementing relevant preventive dental health services to appropriate population groups.

In india, public health dentistry would be a boon..but our politicians and the powers-that-be just wont do it.

As it is, the latest scam that has been unearthed is that of the poor tribals not getting their monthly allowance of rs.250 or 300 from the state govt in maharashtra.

Can you believe this?????

More than rs. 300 crores have been taken in the names of non-existent or dead persons, and all these poor tribals, who have no land to till, no proper homes, no water for miles around, are below the poverty line, are starving.

ok anirudh, ive read the article.

im quoting the last para, which is a summary/conclusion.

"Clinical Implications Generalizability of results to populations other than those studied is limited owing to the age of some of the studies, as well as to clinical and methodological heterogeneity; consequently, the conclusions should be viewed with caution."

so it is non-conclusive.

i like saurabh's idea the best..give them a yearly contract, with free check-ups/follow-ups and a discount for all treatment.

that way, they are with you for a year, and you build a lasting relationship with them.

My bad Arnavaz, i still followed that article. i apologize for my negligence.

Saurabh's idea is indeed great of taking some money over time and discount them when treatment is required. We can easily target and deal with urban lower/middle income patients with this. Its a nice idea.

Next in line is the rural population.How can we help them? (As the same thing turned out to be scam in Arnavaz's former answer.)

My friends, has there been any survey saying that dentistry in India is not affordable when compared to western countries.

There are dental practices for different economic levels of the society.

Dental practice combines two aspects - health and luxury.

Health is affordable but luxury is never going to be such bcoz it is not meant for the poor.

I m sorry to say that medicine & dentistry as a profession has now grown to a business and not a charity.

There are many pvt dental colleges which are there to treat the rural population surrounding them, and also many villages have been adopted by these institutions to take care of their dental health.

Dear Saurabh,

I am happy that you are concerned. My concern is the same. I am trying to say here, that we should be researching on alternatives and techniques which are cheaper. So that, we take less money from the patient yet filling our pockets and not compromising on the quality of treatment by compromising on infection control and disposal of the waste materials.(We know how the small time practices run in the village and sub-urban areas.)

Developing it like a business is not bad but developing it without thinking about the masses and on expense of their well-being is bad. What do you opine?

Anirudh,

Your intentions are very good, but try to think practically once when your peers are having class practice earning the same amount what some dentists do with mass practice.

Also you "cannot" do justice with your work when you are doing mass practice.

Bcoz in the same time quality is what is compromised for quantity.

I am member of a run dental mobile clinic. We provide dental with a affordable price with the patient can pay tothcare in a private clinic. Our politics is to see a lot of patient .the quantity is so important for us we gain our benefit with the quantity of patient we can see and provide tooth care for the day.

Its a very good suggestion Cajouste! We should try to bring this model into practice at other places. Please do share some basic functioning of your camps, so we can learn more from you.

I see that the affordability depends on who we are talking about: government or individuals? For individuals, I see that universal coverage by the State is the best solution, the costs to cover dental treatment comes from taxes (income taxes). This is a welfare policy. Still, there will be costs, and taxes may not be enough to cover all expenses. Developing countries (Brazil in my case) cannot provide universal coverage, decreasing costs has a lot to do with salaries, as most of the costs have to do with this. Unfortunately, dentists and doctors want to have earning twice or three times the salaries of other health professionals. Technology and administrative procedures have marginal costs, but I am not a health manager, someone with experience, please, let me know. Thanks.

Hello,  I agree it is an old question but still unresolved... worse, dentistry is really turning to cosmetic luxury treatment  and tend to  underestimate the general health link priorities  and consequences.

ART was very promising 15 years ago, but unfortunately the clinical results not enough satisfying.... nevertheless the original Idea is still very good, is not surprising that Partial decay excavation interest is growing .... the main problem comes from the poor  GIZ- materials performances.

Interception dental care  using a "modified ART"  protocol, based on heavy-mixed Copper-ZOP-cements can be very affordable, easy and safe used to save many  pulps before to go straight to RCT  or extraction.   .... and not only for undeserved !

Isn't  that a kind of Reverse Innovation? 

PS more on my RG page