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Table of Contents   
ORIGINAL RESEARCH  
Year : 2021  |  Volume : 32  |  Issue : 1  |  Page : 35-38
Is the profession of dentistry losing its yesteryear's glory? An exploratory study from dental students' perspective


1 Department of Public Health Dentistry, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
2 Department of Pedodontics and Preventive Dentistry, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
3 Department of Public Health Dentistry, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India

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Date of Submission29-Jan-2020
Date of Decision13-May-2020
Date of Acceptance08-Oct-2020
Date of Web Publication13-Jul-2021
 

   Abstract 


Introduction: The regard for dentistry as a profession has been declining over the recent years in light of the increasing number of dental students graduating per year with negligible improvement in the utilization of oral health care services. In this context, it is important to document the perceptions and apprehensions of the current dental students as these feelings would have an influence on the roles they assume as dentists in future. Aim: With this background, this study attempts to document the willingness of dental students from three South Indian states to re-choose dentistry given an opportunity. Materials and Methods: This cross-sectional survey was conducted among house surgeons from 12 dental institutions, 4 each from the southern Indian states of Andhra Pradesh, Telangana, and Tamilnadu. The semi-structured questionnaire used in this study consisted of five primary questions along with details on the participants' gender, type of admission. It aimed at documenting the willingness to re-choose dentistry given an opportunity, and the reasons for their willingness or otherwise. A total of 822 students constituted the final sample. SPSS version 20 software was used to analyse the data. Results: Majority of the study participants were from Tamil Nadu, not reported dentistry as their primary career choice, and demonstrated reluctance in re-choosing dentistry given an opportunity. A significantly higher percentage of dental students from Tamil Nadu reported dentistry as their first professional choice. This observation persisted in the response of students for the question on their willingness to re-choose dentistry. Conclusion: The study results demonstrate the declining interest and regard for dentistry among the current dental students with nominal variations between students from the three South Indian states.

Keywords: Dental, dentistry, education, qualitative research

How to cite this article:
Bommireddy VS, Chandu VC, Kommineni HC, Vijaykumar A, Ravoori S, Neeli GS. Is the profession of dentistry losing its yesteryear's glory? An exploratory study from dental students' perspective. Indian J Dent Res 2021;32:35-8

How to cite this URL:
Bommireddy VS, Chandu VC, Kommineni HC, Vijaykumar A, Ravoori S, Neeli GS. Is the profession of dentistry losing its yesteryear's glory? An exploratory study from dental students' perspective. Indian J Dent Res [serial online] 2021 [cited 2021 Aug 3];32:35-8. Available from: https://www.ijdr.in/text.asp?2021/32/1/35/321364



   Introduction Top


Though dentistry is regarded as one of the oldest medical disciplines dating back to 7000 B.C., it is only over the last century that this discipline in health care got streamlined into a definite profession.[1] In the Indian context, refinement of dentistry as a profession became possible with the inception of formal dental education. The first dental college in India was established in 1920 by Dr. Rafiuddin Ahmed in Kolkata.[2] Since then the profession has evolved by leaps and bounds becoming one of the most sought after professions in the country. There has been a consistent increase in the number of dental colleges in India over the years with a pronounced increase seen during 1998 − 2014.[3] At present, there are 315 dental educational institutions in India producing nearly 31,000 dental graduates every year, making India the largest producer of dentists across the world.[4] However, this increase in the number of dental institutions in the country was not demand-driven and neither was this choice methodically informed. Once the supply component in dental care delivery began to outstrip the demand component, the delivery systems started suffering from a reduced number of care seekers which consequently had given rise to a notion that dentistry as a profession is not fruitful anymore, at least not as yielding as it once was. The success of any profession is a complex interplay of a multitude of factors among which financial returns in the profession and societal regard for the profession could be considered the most determining. It is this reduction in societal regard for the profession and the reduced financial returns that prompted the aforementioned notion on the profession of dentistry.

Indian medical education system is an intricate organization with academic merit being not the only factor that warrants admission. While the distinction of this system is largely debated, from the educational institutions' perspective this mechanism ensures full enrollment. On the other side, the mechanism also offers solutions for parents of those students who demonstrated insufficient standards in the entrance examination, to choose a profession of their choice. It is under these circumstances that dentistry enjoyed almost full enrollment throughout the country despite an enormous increase in the number of dental institutions. However, the scenario has apparently been changing. There has been a consistent and considerable decline in the number of undergraduate admissions in dentistry over the last few years.[5],[6] While there could be a number of reasons for this phenomenon, the experiences of current dental students with dentistry and their understanding of the future in dentistry cannot be ignored. In this context, this study attempts to gain insights into the perceptions of current house surgeons in various dental colleges in Southern India to inform policymakers on the prospective ways to streamline the profession, should there be a need.


   Materials and Methods Top


This cross-sectional questionnaire study was conducted among house surgeons from 12 dental institutions, 4 each from the southern Indian states of Andhra Pradesh, Telangana and Tamilnadu. Two-stage cluster random sampling was done, where three states were selected in the first stage and four dental institutions from each of these states were randomly selected in the second stage. All the house surgeons from the selected dental institutions were invited to participate in the study. The primary investigator made a correspondence with the coordinators of this study at each of the 12 dental institutions to discuss the study protocol. The participation in this study is voluntary and consent was obtained from all the willing participants before the questionnaire was administered. The questionnaire was administered to the consented house surgeons among the twelve dental institutions considered in this study in April 2019. The semi-structured questionnaire used in this study was divided into four sections: whether dentistry was participant's first choice; the participant's reasons for choosing dentistry as a career; whether the participant is willing at the present time to choose dentistry if he/she was given an opportunity to re-choose; participant's reasons for their willingness or otherwise in re-choosing dentistry. Details regarding participants' gender and type of admission were collected. The questionnaire was assessed for content validity by four experts in the field of dental education and a pilot test was done among 25 students to evaluate the face validity of the questionnaire. Students who participated in the pilot study were not included in the final sample. Of the 967 students approached, 98 students opted not to participate in the study, while 47 students returned incomplete or partially filled questionnaires. The final sample consisted of 825 house surgeons from the twelve selected dental institutions in Southern India. Approval obtained on 16th February, 2018. SPSS version 20 software (IBM SPSS statistics for Windows version 20, Armonk, USA) was used to analyze the study data. Descriptive statistics, Chi-square test were performed to check the association of participants' regard for dentistry with background characteristics and the geographical location of the institution, and to extract themes that determined participants' responses on the willingness to re-choose dentistry given an opportunity.


   Results Top


Of the 825 study participants, 193 (23.39%) were males. Majority of the participants (36.37%) were dental students from Tamil Nadu, followed by 273 (33.09%) from the state of Andhra Pradesh, and 252 (30.54%) from Telangana. Only 18.06% of the students reported dentistry as their first professional choice. The most common reason for choosing dentistry was reported to be the inability to secure an admission in medicine. There was a statistically significant difference based on geographical location with regard to students' response to dentistry as their first professional choice [Table 1] and the reasons given for choosing dentistry [Table 2]. A significantly higher percentage of dental students from Tamil Nadu reported dentistry as their first professional choice. This observation persisted in the response of students for the question on their willingness to re-choose dentistry if they were given an opportunity [Table 1]. A total of 35% of participants from Tamil Nadu demonstrated willingness to re-choose dentistry, while only 12.3% of students from Telangana and 23.07% of students from Andhra Pradesh showed willingness to re-choose, given an opportunity. However, no significant differences were noted in the interest of students to advise dentistry as a professional choice for their friends based on the geographical location of the students [Table 1]. Not more than a quarter of the students from all the three states included in the study expressed interest in recommending dentistry as a career choice for their friends. The scope that the profession offers to make people smile was the major reason for students' willingness to re-choose dentistry [Figure 1], while mental stress was the most common reason for the unwillingness to re-choose dentistry. The other reasons for students' reluctance in re-choosing dentistry were financially non-profitable nature of the profession and physically demanding nature of the profession [Figure 2].
Table 1: Geographical variations in the responses given by students regarding their career choice

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Table 2: Geographical variations in the responses given by students regarding the reasons for choosing dentistry

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Figure 1: The reasons reported by the students for their willingness to re-choose dentistry

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Figure 2: The reasons reported by the students for their reluctance to re-choose dentistry

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   Discussion Top


It is beyond doubt that the profession of dentistry has made great strides over the years. There has been tremendous expansion of the dental education in India since 1998. During the period of 16 years from 1998 to 2014, 206 new dental institutions were established in the country which accounts for an increase by 215.9%.[3] The reports on the quality of dental education and the students' viewpoints on the learning environment in dental institutions are not very encouraging.[7] In these circumstances, the results of this study that the majority of students were reluctant in re-choosing dentistry and would not suggest dentistry as a professional choice for their friends are not surprising. One of the important basis for the observation of geographical variation in students' preferences relating to re-choosing dentistry could be found in the cultural and attitudinal differences between the students from different states in general. Another obvious reason was dentistry being the first career choice for considerably more students from Tamil Nadu compared to the states of Telangana and Andhra Pradesh, which highlights the inherent interest among students from Tamil Nadu towards the profession that could have prompted them to respond positively about re-choosing dentistry given an opportunity. The fact that less than a quarter of the students participated in this study were willing to recommend dentistry as a career choice for their friends is reflective of the skeptical nature of students regarding their future as dental health professionals and another reason could be to avoid further competition in an already competitive environment.

This study highlights the apprehension of dental students about their future roles as oral health care professionals. The analogy of supply-demand consideration in marketing applies in this context. In the financial market, when the supply component exceeds the demand component, the prices of the products drop. Similarly, when the available dental manpower is more than what is required to meet the demand for oral care, the regard for the profession diminishes among prospective students as the financial returns from the existing demand for oral health care have to be shared among an ever-increasing supply component.[8] A report on the available dental manpower in Tamil Nadu by Prabu et al. revealed that the dentist to population ratio in Tamil Nadu was 1: 3667 while the recommended ratio by the world health organization was 1:7500.[9] These numbers in the states of Andhra Pradesh and Telangana would not be too different. Barring the discussion on the reasons for geographical disparities in the available dental manpower between rural and urban areas, the available manpower is clearly more than what is demanded from the public.

When the students were probed about the reasons for their reluctance to re-choose dentistry, financially non-profitable nature of the profession, its physically and mentally demanding nature emerged as the major reasons. These observations highlight the expectations students have about their future career roles. It was reported in the literature that the image of oral health care professionals in some parts of the world is associated with wealth and prestige.[10] However, the current Indian dental students cannot associate their future careers with wealth and prestige, given the circumstances. Few students who demonstrated willingness to re-choose dentistry given an opportunity opined that the relatively inexpensive nature of dental education compared to medical education suits them, and some students felt that the profession has more scope abroad. In a study conducted in British University of Egypt in 2016, 73.3% of students expressed satisfaction about their career choice as a dental professional which is in contrast with the results of the present study.[11] Societal reputation, financially profitable nature of the profession were reported to be the main reasons for choosing dentistry by the dental students of Damascus University, Syrian Arab Republic.[12] These findings are in accordance with the thought process of the students in the current study who demonstrated reluctance in re-choosing dentistry because of these reasons. In a study conducted by Aguiar CM et al. among Pernambuco dental students in Brazil, dentistry was not the first career choice for only less than 15% of the students, which is in contrast with the observations made in the present study where dentistry was the first career choice for only 18.06% of the students.[13] Halawany SH reported dentistry as the primary career choice among Saudi dental students in 2014.[14] Similar to this study, in a study conducted among dental students in Bhopal, 22.6% of final-year students reported choosing dentistry out of their own interest.[15] This is a reflection for the fact that the dental students in the present study lack extensive knowledge and realistic expectations about the careers they are assuming, but follow the path of least resistance in making their career choices.


   Conclusion Top


The study results demonstrate the declining interest and regard for dentistry among the current dental students. Though slight geographic variations were observed between the students belonging to different states in their responses regarding dentistry being the first career choice, majority of students regardless of their geographical location, were reluctant to re-choose dentistry given an opportunity. These findings raise concerns about the future of the profession in the country that produces the largest number of dental graduates per annum in the world, and must receive careful attention from all the stakeholders.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
History of dentistry: Ancient origins. American Dental Association. Available from: https://www.ada.org/en/member-center/ada-library/dental-history. [Last accessed on 2020 Jan 2].  Back to cited text no. 1
    
2.
Elangovan S, Allareddy V, Singh F, Taneja P, Karimbux N. Indian dental education in the new millennium: Challenges and opportunities. J Dent Educ 2010;74:1011-6.  Back to cited text no. 2
    
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Jaiswal AK, Srinivas P, Suresh S. Dental manpower in India: Changing trends since 1920. Int Dent J 2014;64:213-8.  Back to cited text no. 3
    
4.
Yadav S, Rawal G. The current status of dental graduates in India. Pan Afr Med J 2016;23:22.  Back to cited text no. 4
    
5.
Bhandary S. (2019, September 15). 40% dental college seats in Maharashtra still vacant after three rounds. Hindustan Times. Available from: https://www.hindustantimes.com/mumbai-news/40- dental-college-seats-in-maharashtra-still- vacant-after-three-rounds/story-RKqF3t683CKpYhscikGjRK.html. [Last accessed on 2020 Jan 3].  Back to cited text no. 5
    
6.
Mahal PS. (2019, September 16). BDS seats go vacant for 6th year in a row as dentists remain underpaid. Hindustan Times. Available from: https://www.hindustantimes.com/cities/bds-seats-go-vacant-for-6th-year-in-a-row-as-dentists-reman-underpaid/story- RWY7XzBDhXa9I6G0HUuVCK.html. [Last accessed on 2020 Jan 3].  Back to cited text no. 6
    
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Vasthare R, Saha S. Dental educational environment in institutions of South East Asia. Indian J Public Health Res Dev 2019;10:185.  Back to cited text no. 7
    
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Nash KD, Brown LJ. The market of dental services. J Dent Educ 2012;76:973-86.  Back to cited text no. 8
    
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Prabhu D, Nirmala S. Dental manpower in Tamil Nadu state, India and its implications. Int J Curr Res 2018;10:72713-8.  Back to cited text no. 9
    
10.
Al-Hallak KR, Nassani MZ, Heskul MM, Doumani MD, Darwish M. Reasons for choosing dentistry as a career among dental students in Saudi Arabia. Eur J Dent 2018;12:275-80.  Back to cited text no. 10
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11.
Kabil NS, Allam GG, Abd El-Geleel OM. Motivational reasons for choosing dentistry as a professional career and factors affecting specialty choice among final year dental students. Future Dent J 2018;4:308-13.  Back to cited text no. 11
    
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Mashlah AM. Dentistry students' reasons for choosing dentistry as a career in Damascus university. East Mediterr Health J 2012;18:508-14.  Back to cited text no. 12
    
13.
Aguiar CM, Pessoa MAV, Camara AC, Perrier RA, Poli de Figueiredo JA. Factors involved in the choice of dentistry as an occupation by Pernambuco dental students in Brazil. J Dent Educ 2009;73:1401-7.  Back to cited text no. 13
    
14.
Halawany HS. Career motivations, perceptions of the future of dentistry and preferred dental specialties among Saudi dental students. Open Dent J 2014;8:129-35.  Back to cited text no. 14
    
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Bhagwani H, Mishra SK, Yadav NS. Choosing dentistry as a career: A matter of concern – a survey. N Niger J Clin Res 2017;6:16-20.  Back to cited text no. 15
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Correspondence Address:
Dr. Vikram Simha Bommireddy
Department of Public Health Dentistry, III Floor, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijdr.IJDR_111_20

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