Archives of Medicine and Health Sciences

CASE REPORT
Year
: 2017  |  Volume : 5  |  Issue : 1  |  Page : 92--94

The curse of quackery in dentistry: A double-edged sword


N Geon Pauly, Sukanya Warrier, Roopashri Rajesh Kashyap, Prasanna Kumar Rao, Raghavendra Kini, Gowri P Bhandarkar 
 Department of Oral Medicine and Radiology, A.J. Institute of Dental Sciences, Mangalore, Karnataka, India

Correspondence Address:
N Geon Pauly
Department of Oral Medicine and Radiology, A.J. Institute of Dental Sciences, Kuntikana, NH-66, Mangalore - 575 004, Karnataka
India

Abstract

The high price of dental treatment, repeated dental appointments, poor accessibility to dental clinics, illiteracy, and lack of awareness are the reasons for thriving of quackery in dentistry. In many developing countries of the world like our own, where dental health-care facilities by college-/university-trained personnel are limited and hospitals are few and a far or very expensive, the underprivileged of the society go to unqualified persons (known as quacks) to get dental treatment. Many dental quacks are practicing roadside, which makes money by doing unethical practice and ultimately hampering patient's oral health. It is thus a challenge to the dental practitioners to not only fight against this fraudulent of dental quackery but also to educate and convince the patient to distinguish between the quacks and dentists so that they get guided to take the right treatment.



How to cite this article:
Pauly N G, Warrier S, Kashyap RR, Rao PK, Kini R, Bhandarkar GP. The curse of quackery in dentistry: A double-edged sword.Arch Med Health Sci 2017;5:92-94


How to cite this URL:
Pauly N G, Warrier S, Kashyap RR, Rao PK, Kini R, Bhandarkar GP. The curse of quackery in dentistry: A double-edged sword. Arch Med Health Sci [serial online] 2017 [cited 2021 Nov 30 ];5:92-94
Available from: https://www.amhsjournal.org/text.asp?2017/5/1/92/208197


Full Text



 Introduction



Dental diseases are inarguably one of the most prevalent diseases in our community, yet have been neglected for long by the general population. However, since the past two to three decades with increased awareness, literacy, emphasis on esthetics, advanced and sophisticated dental treatment, equipment, and economic development have led to complete turnaround in the field of dentistry in India.[1] On the other hand, the rising need for dental treatment has led to flourishing of street dentistry. Quacks are those who have observed and self-learned a few techniques of dentistry either by assisting dental surgeons or inherited it from their families and adopted it as a profession.[2] Here, we present a case report of a 54-year-old male, who unknowingly became a victim of such malpractice.

 Case Report



A 54-year-old male, a daily wage laborer by profession, hailing from Davangere district, came to our dental outpatient department with a chief complaint of an irritating denture in lower right back teeth region. He narrated that the denture was placed over 1 year back in his hometown by a practitioner who claimed to be a dentist and was assured that it was the best treatment possible for the missing space. He had no notable medical issues and walked with a normal gait. He was moderately built and was well nourished. He had undergone many previous dental treatment including fixed partial dentures and removal of many teeth, for which he was willing for replacement. On examination, an acrylic cold cure filling was seen between mandibular right first and third molar. Mandibular right second molar was missing, and the acrylic filling had been placed such that it extended anteriorly onto a cavity on the disto-occlusal surface of the adjacent first molar, posteriorly contacting the adjacent third molar, and extending about 10 mm inferiorly lodged below the undercuts of the adjacent teeth [Figure 1]a. Using an explorer and periosteal elevator, an attempt was made to dislodge it but went unsuccessful. Finally, a portion of the acrylic plate below the undercut of the adjacent first molar had to be broken so as to successfully remove it from its place [Figure 1]c. After removal, it was observed that there was adequately visible bone loss; the alveolar mucosa had erythema and was tender to palpation. Furthermore, there was a deep cavity in relation to the adjacent first molar though it was nontender to palpation and percussion [Figure 1]b. An intraoral periapical radiograph was advised, and it showed a horizontal bone loss in relation to the mandibular right second and third molar region, and an ill-defined radiolucency involving the pulp on the disto-occlusal aspect of the mandibular right first molar with loss of lamina dura periapically indicating for an endodontic evaluation [Figure 1]d. Other findings included missing teeth in relation to right mandibular canine and left mandibular first and second molars and cervical abrasion in relation to right mandibular first premolar and first molar. The patient was advised for oral prophylaxis followed by restoration of required teeth and prosthetic rehabilitation with endodontic treatment wherever indicated. The patient was also explained about the faulty treatment which was the cause of pain and was advised to exhibit necessary precautions in the future.{Figure 1}

 Discussion



Quackery has been defined as “The fraudulent misrepresentation of one's ability and experience in the diagnosis and treatment of disease or of the effects to be achieved by the treatment offered.” The term “Quackery” is derived from the word quacksalver, i.e., the person who boasts his slaves.[3]

There are numerous reasons for the implement of the quacks in the society such as:[4],[5]

When trained and competent practitioners are in short supplyWhen their charges appear prohibitive to a segment of the populationAbsence of the basic primary health-care approach in dentistryLack of awareness and knowledge among the common man regarding who is a dentist and who is not.Poor patient: dentist ratio in the population.

These have led the dental quacks to have flourishing business, especially in rural and semi-urban area.[5]

In India, under Chapter V, Section 49 of the Dentist Act of 1948 requires dentists, dental mechanics, and dental hygienists to be licensed. These quacks can be penalized under The Dentist Act leading to imprisonment and penalty, but stricter laws need to be reinforced and implemented.[6]

However, the best way to tackle this menace is to provide affordable and accessible treatment option to the rural population in particular. There is a lack of primary dental health-care centers in the rural areas; it will be highly beneficial to have one basic dental clinic for basic treatment at each primary health center being run by government, and dental professionals can be recruited as mandatory rural posting for graduates and postgraduates post the completion of their course has not yet being put into effect. A comprehensive oral health program should be formulated and implemented under National Rural Health Mission to make dental care more accessible.[6],[7]

Effective use of social media such as newspapers, local televisions channels, and the ever rising use of smartphones even among the backward socioeconomical classes can be used as a positive tool to propagate messages regarding the need for dental treatment and raise dental awareness among the uneducated. Together with this, these quacks may be given some form of formal dental training and allowed to perform basic dental treatment under registration. The World Health Organization suggests of having new dental auxiliaries such as dental aid, dental licentiate, and frontier auxiliaries with little training to work in rural remote areas.[7]

Until the government intervenes, takes them into the health system, and provides a stable means of income, there are more chances that the quacks may thrive to earn money by practicing quackery.[8] Another pressing issues are that some cities within a state have a huge number of colleges leading to underutilization, whereas the other cities in the same state are deprived of dental college or hospital, and the population is left with no choice but to has to rely on private practitioners and quacks for dental treatment. Hence, it is important to ensure that new colleges sanctioned here after are more towards rural areas and also make sure that the existing colleges open even more number of health-care centers in their rural vicinity.

 Conclusion



Decade after decade, dentistry today has transformed into a rapidly growing field and is ranked as one of the most respected professions in the country. On the flip side, despite an increase in the number of dentists over the years, the count of dental quacks practicing dental treatment has also been on the rise, especially in the rural areas. It is thus the duty of every dental surgeon of the country to protect the reputation of our prestigious profession being tarnished by the unqualified unauthorized dental quacks and to protect the oral health and well-being of patients. Furthermore, there is an urgent need to fill the gap between the availability of trained dental professional for the urban and especially the rural population, for which the government must intervene and take necessary steps. An urgent need to address this thriving issue is not only that it hampers the work, livelihood, and credentials of the dentist but also can severely affect the health of the patient due to their nescience and unethical means of practice. Indeed, a double-edged sword that is ripping our society and only – “A stitch in time can save nine.”

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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