Special Needs Dentistry is Nowhere in India: Dr. Usha Mohandas

Prof Dr Usha Mohandas; President of the Indian Society of Pedodontics and Preventive Dentistry  is Principal of the VS Dental College Bangalore. Over her last two years as president she has gained the reputation of one who does not to mince her words. In this hard hitting interview with DCSN she tells us where she sees special needs dentistry in India - past present and future.

Dr Usha Mohandas: Before you begin let me say I will be absolutely honest….

DCSN: Where do you see special needs dentistry  India?

Dr UM: Nowhere!

DCSN: What do you feel can be done to correct that perception?

Dr UM: Firstly you need to have integrity among the fraternity, second; you need a common consensus on where we need to be on this issue and only then can you move forward on this issue.

DCSN: We are supposed to be pedodontists and preventive dentiststs, what preventive care do you feel we can provide children with special needs?

Dr UM : I feel as ISPPD president, the ISPPD should first know what ISPPD stands for. I feel all of us; and I don’t just mean committee members, but every pedodontist should come together, either in the for of a symposium or some other common forum to reach out to children with special needs. They are the ones who need us the most; not children who can be managed by any dentist. I feel that many dentists have no idea as to how many handicapped children are there in this country or what our obligations to them are. When you say dentistry for the “handicapped” I feel it is the dentist who is handicapped. This will require a spirit of cameraderie and will also require someone who to be  extremely committed an extremely human.

DCSN: Websites like these are reaching out to an extremely small audience; what in your opinion can be done to reach out to large sections of our population?

Dr UM: It is true that a very  very small percentage of our population is cyber savvy, but it is a very good beginning for those of you who are young and are interested in using the internet for a positive purpose. My objection is however that the internet is turning from .com to a dot con. There are people who simply “borrow” ideas from here and there making it impossible for people to get credible information.  Also there is a tendency to overstate western models. A Western experience can only serve as a base for creating something simplistic yet highly effective.This has to be done by holding several central forae so as to alllow us to create a strong central structure. Only  s believe you need a strong central sturcture only when this is done can we move on and truly disseminate this inforamtion to every region of the country, be it north, south east or west. This will take time and until then I believe we must work as best as we can for only when this is done can we move on to a larger base.

DCSN: Very often Pediatric Dentists are perplexed by the LA vs GA question. Should we try to treat children with Special Needs in the dental chair or as one senior professor told us, do you feel it is “Impractical”?

Dr UM: I believe that a person who recommends GA  for any child should be shot!!!.... Unless it is ABSOLUTELY indicated. There are very clear guidelines on this and I feel we should tread very carefully in this field. I think the challenge of being a pediatric dentist is the struggle, the skill involved in managing a child in the dental chair. I feel I have failed as a pedodontist if I resort to General Anesthesia because I feel it is “Easy” or worse, because it is “lucrative”. A lot many people would like to work on children when they are sleeping, it is cowardice and because of the money involved I would even go so far as describe it as abuse. I am a traditional Pedodontist who believes in doing every case under LA unless it is absolutely contraindicated. I will resort to GA only as a last resort and the guidelines for those guidelines are evident to every ethical dentist, and they will use GA as a necessary tool; not the next successful pedodontic business strategy.

DCSN: We get a lot of mail from parents of children with special needs asking about a diet to prevent decay. Where do you think we can step in and if there is some programme that you would like to be your legacy what would that programme be?

Dr UM: Firstly my priority would not be children who are worried about a diet, but children worried about food; getting one square meal a day. That said, there is a need to bridge the vast gap that exists between the haves and the have nots in our country. I truly believe that in order to reach dental care to all children with special healthcare needs requires a burning desire to serve and not just make money. I truly believe we can tap into the resources available, so many people donate to the cause of medical needs for special children, we can set up charitable trusts that reach dental care to every child with special needs not just the privileged few. I personally have setup a foundation called gift a smile, you can contact us at www.giftasmilefoundation.org . This forum reaches out not only to service providers but also to parents, who play the most important role in the carrying out of home care instructions.

DCSN: In a world where there are so many privileges in the hands of so few, what are your views on fund raising in India? Do you feel that that we have a long way to go in the evolution of a viable dental insurance programme?

Dr UM : Firstly let me say that I do not feel that funds raised always reach the people they were intended for. The important thing is that we have to start somewhere. I personally have been able to reach out through the corporate sector to over 75000 children in the span of one year, This has been done through the bare minimum collection from each individual. Furthermore, we have also been able to start a Dental Insurance of sorts among the rural children of Bangalore. A programme that collects just Rs.20 from every child at the beginning of the year and then provides dental  health care all year round. This programme was inaugurated by His Excellency Dr APJ Abdul Kalam himself. We are doing wonders through various programmes such as mid-day meals and so on. It’s really easy if you keep it simple. If you start simple it is easy to go big, I feel that you need simple management techniques, along with able executors which I feel is seriously lacking in our Indian Pediatric Dental fraternity. I think our committees should be able committees with the burning desire to succeed, and not just political committees that pull the society in whichever direction is suitable.

DCSN: Finally what would be your advice to any young Pediatric Dentist who would want to persue this field?

Dr UM: The youth are the key to the success of any programme, they have the energy and the “Brawn Power”. The young also have newer and more innovative ideas and can take the profession to great heights, provided they fall back on the experience of the old.