Article Written By EIH Researcher And Writer
Aaloy Gangopadhyay
The dentistry of India started from the Indus Sarasvati Civilization in and around 7000 BCE. They were usually known as healers who would use woodworking tools, like bow drills, to repair cavities and remove decay, while other tools were used to extract teeth. Interestingly, dentistry started in lanes, streets, and roads before the coming of institutionalized medical centers. Many historians have argued that this practice of street dentistry was prevalent even in Egyptian, Sumerian and Chinese civilizations and there was a cooperative interaction across civilizations for making innovations in this profession. Practically dentistry was related to extractions and treating pain.The major change came from Hippocrates, Cornelius Celsus, Sushruta and Acharya Charaka.
Sculpture of Dentistry in Ancient India
Hippocrates (460-370 BCE), a Greek Physician who noted patterns of teeth erupting in infants and children as well as the pattern of baby teeth being lost as adult teeth would come in. Additionally, he wrote about treating gum disease and using wires to stabilize loose teeth and broken jaws to prevent extraction. Maharshi Sushruta (800-700 BCE), an Indian Physician in his book “Sushruta Samhita” wrote about Ayurveda and dentistry in which he elucidated detailed procedure for treatment of oral, dental, maxillofacial treatment and amalgamation. Acharya Charaka (100-200 CE), Father of Medicine through Ayurveda brought improvisations to reduce pain during dental treatment. In his book “Charak Samhita,” he has described the medicinal qualities and functions of 100,000 herbal plants. Later in Ancient Rome, documents written by Cornelius Celsus (25 BCE- 50 CE), a medical writer, describe treatments of oral diseases and how to treat them with medicated ointments and astringents.
Archaeological Remains of Dentistry, Indus Sarasvati Civilization
The knowledge of street dentistry passed from generation to generation through practical utility. It was mostly done by men. During Delhi Sultanate and Mughal Empire, practicing street dentistry became popular as sections of people from poorer strata of the society irrespective of religion, caste, and creed joined and contributed for dental treatment of the masses. After Independence of India in 1947, street dentistry declined due to legal barriers and imposition of certain rules for safety and hygienic dental treatment. Chapter V and Section 49 of the Dentist Act of 1948 requires dentists, dental mechanics, and dental hygienists to be licensed, making street dentistry illegal. Indian Medical Association has opposed street dentistry citing hygienic precautions and spread of diseases like HIV-AIDS through non sterilized dental treatment equipment.
Street Dentistry in South India
In India, street services are plentiful, with dentists operating alongside other street services, such as apothecaries, repairmen, and barbers. The tools used by the street dentists are mostly self made tools like pliers, screwdrivers, dividers, self-acrylic materials, etc.. They also buy tools and medicines for use. They remove the tooth without any asepsis, fill the tooth with self curing acrylic. For replacement many times they use the extracted tooth, trim the root, and fix it with the adjacent tooth using self-curing acrylic. Sometimes they also use wires to stabilize the tooth or denture with the support of adjacent teeth. These types of replacements are called fixed dentures. They also use adhesives for dental treatment.
Tools used by Street Dentists
These practitioners charge far less than licensed dentists, often charging as little as 125 rupees for a procedure such as a bridge, which, at a licensed dentist, could be as expensive as 10,000 rupees. The socio-economic problems have always compelled the masses to take up these hereditary practices of dentistry due to the high cost of studying dentistry. It is also difficult to get a license due to certain compliances needed by practitioners like passing licensing exams, registration criterias, etc. Dental Council of India solely controls this licensing system and sometimes it is out of reach of many students.
Despite having 80,000 dentists with degrees every year, only 11,200 join the field of licensed practice. Today, the profession of street dentistry is slowly and steadily vanishing or dying due to many reasons The change in lifestyle and reliability of costly clinics have reduced customers for street dentists. The hygiene issue and tools used for treatment have caused avoidable approaches towards these dentists. The Government of India has not taken any steps to alleviate the dire poverty of these dentists.
Interestingly few people are still continuing with this practice despite the so-called money making medical professionals calling them “Quack Dentists”. Street dentists are treated as a source of embarrassment. Many street dentists now focus on teeth polishing and fixing false teeth. They urge that serious dental problems must be treated by qualified dentists as past medical complications by treatment of street dentists have created trouble.
Street Dentistry in Punjab
The future of street dentistry depends on the symbiosis of these people and dental practitioners. The quicker the symbiosis is halted and the quicker rational quality care be made universally available, the faster will the address be issued. Dentistry has come a long way in the last century and a half, to the point where today it is ranked as one of the most respected professions. It is incumbent upon dentists everywhere to protect that hard-earned reputation by cooperating with these street dentists and giving them proper medical training so that the lost profession gets improved and stays with time.
Bibliography
“The Lost Generation: Chronicling India’s Dying Professions” Nidhi Dugar Kundalia
“The Excruciating History of Dentistry: Toothsome Tales & Oral Oddities from Babylon to Braces” by James Wynbrandt
“History of Dentistry” by Akhter Hussain, Faizan Ahmed Khan
“Dental Amalgam:An Update” by National Library of Medicine, USA
Web References
https://www.nytimes.com/2005/06/07/health/indias-street-dentists-are-a-vanishing-breed.html
https://www.telegraph.co.uk/travel/destinations/asia/india/galleries/the-street-dentists-of-india/
https://mikehambydds.com/blog/the-history-of-dentistry-ancient-origins
https://www.dailypioneer.com/2016/sunday-edition/on-the-brink-of-oblivion.html
