I REFER to the letter “Do we have enough dentists?” (StarEdu, Sunday Star, July 17) by Professor Dr Rahimah Abdul Kadir, who is of the opinion that Malaysia still needs to produce more dentists.
I beg to differ.
In 2011, there were 4,253 dentists practising in Malaysia. In 2019, there were 10,801. This increase has caused a drop in the dentist-population ratio from 1:6,810 in 2011 to 1:5,000 currently. Such a tremendous increase in the number of dentists (154%) in just eight years raises the question: "Are we producing too many dentists?"
While Dr Rahimah outlined her opinion from an academic's point of view, I wish to present mine from the ground level.
Our leaders proudly hail the drop in dentist-population ratio as an achievement for the country. They believe that an increase in the number of dentists will lead to:
> Less waiting time for patients to receive treatment;
> Reduction in cost of dental treatment due to increase in competition; and
> Correction of the uneven distribution and "mislocation" of dental clinics.
Unfortunately, this is only half true.
Each of us has our own preference for dentists. If I believe dentist A is good and has great skills, I will wait for him to treat me. It is illogical that a rational person would simply choose a dentist just because one does not have to wait!
It is also expensive to set up and maintain a dental clinic. In order to have a sustainable practice, the clinic must be located in an area with a reasonably big population. Thus, Selangor and Kuala Lumpur have the largest number of dental clinics in Malaysia.
Currently, a dental clinic may cost between RM100,000 and RM200,000 to set up. Regardless of how many patients a dentist treats per day, the equipment will depreciate with time. With fewer patients to treat due to increased competition, the dentist will eventually have to increase his fee to cover the cost of depreciation. This will make dental treatment less accessible, especially to people in the B40 or lower-income group.
The reasons behind the dentist's choice for setting up his practice are mostly personal, hence increasing the number of dentists will not correct the uneven distribution of dental clinics.
In her letter, Dr Rahimah also mentioned the high prevalence of caries and periodontal disease among the Malaysian population. I will not dispute this fact. However, we have to admit that awareness of good dental health is low in our society. While there is a lot of dental work that needs to be done, increasing the number of dentists will not solve this problem if people do not want to seek treatment.
By the way, non-specialist (general) dentists do not treat jaw, facial bone fracture or oral cancer. At the most, they can pick up the case early and refer the patient to a dental specialist for further management.
What Malaysia lacks right now are dental specialists, such as oral maxillofacial surgeons, periodontists, orthodontists, endodontists, paedodontists and prosthodontists. We should find ways to produce more of these specialists instead of flooding the market with general dentists.
It is impossible to use a single and simple ratio, such as the dentist-population ratio, to conclude that Malaysia has too many or too few dentists. Perhaps a better approach would be to measure the take-home pay of a dentist who has worked for one to five years in private practice after completing his/her compulsory government service.
If the pay is below the median for M40 income, then the dentist, who is a professional, is not on par with other professionals such as lawyers, accountants or engineers.
Furthermore, if there is a decline in the take-home pay of young dentists, this will clearly indicate the oversupply of dentists in the market, which works on the principle of demand and supply.
Last but not least, Happy 50th Birthday to the Dental Faculty of Universiti Malaya, my alma mater.
DR NG CS