I am indeed delighted to interact with the Students and Staff of the Army College of Dental Sciences (ACDS), Secunderabad. I extend my greetings to the Principal, faculty members and students of this prestigious institution which is promoting the welfare of children of serving and retired army personnel and war widows. I am happy that the students of ACDS have performed very well in their examinations. My greetings to all of you. I congratulate the faculty members for shaping the young minds. Medicine is the most challenging field where human pain has to be combated with the best of human intelligence and care. I would like to talk to this audience on the topic "Giving confidence to Smile: Our Mission".

Indigenous development experience

I would like to share the experiences witnessed in our country on the development of dental implants. INMAS and DRDO have been working on this development project for over fifteen years. INMAS team has developed dental implants, bone plates, titanium mesh and bone augmentation materials. They had identified NFTDC (Non-Ferrous Technology Development Centre) as the production agency for bone plates. For implants and surgical kits, they have transferred technology to private firm. They have made more than hundreds of implants and supplied to multiple health centres in the country both in the civil and defence establishments. The oldest standing case in this test is fifteen years old and the patient is extremely happy with the implants. Use of these implants in different places has given good results. In some cases, the implants have been used as part of restoration after post cancer treatment. The development team has shown enormous perseverance in progressing this project. I am sure dental implants developed by DRDO and produced by the industry will be used by the dental community in different parts of the world, so that product becomes competitive and the Indian consumers are able to get the product at an affordable cost. I would suggest the Dental Implantology Centre of ACDS to work in partnership with NFTDC and other implant development agencies in the country.

Solution to development, production and induction

Even after sound development, there is no guarantee that the equipment/material will be smoothly produced and inducted into the dental care market. It may be true both in India and abroad. I have been closely associated with the development of titanium dental implants and associated fitment hardware by our laboratories. Work in the laboratory gets carried out with utmost enthusiasm but beyond that the scientists encounter hurdles at every stage. The dental care community assembled here can create a consortium of doctors, industrialists, hospitals and development laboratories. This consortium in consultation with the corresponding government agencies could empower the development process and enable the smooth transition from development, trial production, quantity production, multi-centric trials leading to the induction of equipment or product into the hospitals by the ethics committee. Such a forum is essential for compressing the time design, development, production and induction currently encountered by the development institutions and scientists.

Cost effective dental care

I understand that Prosthesis is the replacement of an absent part of human body by some artificial part such as an eye, a leg or a denture. Prosthetics is the art and science of designing and fitting artificial substitutes to replace part or missing tissues. Dental prosthetics deals with its application in oral and para oral structures. It aims at restoring and maintaining all oral functions like mastication, speech, swallowing, comfort, appearance and health of the patient by the replacement process. But the main problem in this treatment is that all the equipment and materials needed for the designing and fitments are presently imported. Even the consumables in many cases are imported. Dr Ravindranath told me the dental chair with all the connected instrumentations is imported by all our hospitals. But as an engineer I believe, Indian industries with the assistance of our R & D labs and the doctors can definitely build the dental chair in a cost effective way. It is my experience whenever a doctor and an engineer work together, we have witnessed many breakthroughs - for example cardiac stent and Floor Reaction Orthosis (FRO). Some industries have started manufacturing few types of materials and equipment for dental systems in the country. But this has to increase substantially.

Networking of Dental Centres

There is a need to network the dental centres located in different parts of the country to generate clinical database which will be useful for research. This should be applicable both for civil and military dental centres. It can also be made available in the Internet for sharing of information and academic research leading to path breaking findings. This type of connectivity will enable research on different dental problems pertaining to different regions in the country. Also the clinical database of one particular surgeon will be available to other dental surgeons for deciding on the line of treatments for similar cases. The region specific research database could be used for suggesting preventive medicine or preventive care to the local community based on doctor?s experience. We need to have a centralized database on Indian dental problems, cases, remedies and solutions. Also it will enable detection of related diseases arising out of water and other environmental factors in a particular region. This could help provision of treated water and provide better health for the community as a whole. Better use of tele-medicine for the dental care in the remote villages will enable the doctors to examine the patients using intra oral X-rays through digital sensors and provide consultancies through Virtual Dental Clinics which can provide knowledge to the field centres.

Mobile Clinic

I am told mobile dental clinics are functional in certain places like Delhi, Bombay and some cities in Karnataka. They are providing treatment in certain urban slums and certain selected village areas. I suggest that this experience of mobile clinics has to spread all over the country. ACDS can consider establishment of mobile dental care clinic which can move from one place to another and provide treatment to the people in the neighbouring rural areas. The dental care personnel posted to Army Units from ACDS can also provide dental care services to the rural population and provide proactive Medicare among the village community as a societal mission which will enhance the bond between the civil and military personnel.

Educating the soldiers on dental care

There is a need for educating the soldiers on dental care. Many of them are in the habit of chewing pan, gutka, tobacco and smoking which have a detrimental effect on the dental health leading to cancer. For preventing such occurrences a campaign is needed to educate the soldiers on dental hygiene and suggest simple means of preventing damage to the dental system. Every doctor who takes care of oral treatment should consider himself as an educator of the society and educate the patients and the family who accompany them on preventive dental care.

Traditional dental care

In different parts of the country, there are many traditional practitioners who are providing health care products from herbal plants in the form of powders for the dental care. Still many people in the villages make use of these products and some of them are able to maintain sound dental health. My father lived for 103 years. Up to the age of 98, all his teeth were intact. He did not have to go to any dental clinic throughout his life. Only during his later years, I realized that he was using neem sticks for brushing his teeth both in the morning and before going to bed. It was an isolated case in my family. There is a need to identify some areas of excellence and carry out systematic research in the area using the knowledge base of the traditional practitioners. A case study could be conducted about the use of neem tree material as a cost effective solution for promoting dental care in the villages. Apart from neem, efficacy of ingredients like clove and herbs could also be studied for use in dental paste and powder. We need to examine them more critically and make use of traditional system knowledge base for the welfare of people. This could be done by having a workshop specially dedicated for assembling the traditional system practitioners and having a constructive discussion.

Research focus

Advances in materials like composites, polymers, ceramics, and fiber reinforced composites, silicon have found their place in dentistry. By using laser technology, emerging nano technology, tele-radiology, digital imagery and virtual reality etc., the rehabilitation process will be modeled and energized for providing customized dental treatment. Scientists from genetic engineering are working towards development of individual tissue organs through the use of stem cells. When any organ of the human body can be rehabilitated using individual?s own stem cells, it will not be far off when we can see reconditioning the dental systems through stem cells used for promoting the growth of tissues and bones. Intensive research is needed for realizing this breakthrough. Very soon we may see a person having real natural teeth either replanted or reconditioned in place of the missing teeth.

Conclusion

Self-reliance is very essential in the dental health care sector. The technologies have been conditioned to function optimally for the ambience of a particular country. The effective support services for proper maintenance of expensive medical and dental equipments are generally not readily available. The Army College of Dental Sciences could consider introducing a special diploma course for imparting maintenance training on dental equipment. This will have tremendous employment potential. I urge the students and faculty members of this college to be a catalyst to reinforce self-reliance effort for promoting indigenous technology and traditional health care system for dental treatment, as it is country centric.

My best wishes to all the members of Army College of Dental Sciences success in their mission of removing the pain of the people.

May God bless you.

Five Point Oath for Dental Professionals

1. We realize dental profession calls for removing the pain. Removing the pain is a God?s mission.

2. We will always give part of our time for treating patients who cannot afford.

3. We will treat at least 20 rural patients in a year at minimum cost by going to rural areas.

4. We will encourage the development of quality indigenous equipments and consumables by making use of them in all our operations assuring the reliability of the products.

5. We realize preventive dental care is equally important for the health of people. We will promote dental hygiene among the children through dental camps in schools.

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