'We have no choice but to hike patient fees,' say Mumbai's dentists

Dr Manish Guri with a patient at his Ghatkopar clinic

Having shut shop for more than two months, most city dentists are now charging extra to make up for their losses. Even after having opened their clinics, dentists are barely seeing any patients owing to COVID-19 fears among people, resulting in scant business for the doctors. To add to their woes, disinfectants, PPE kits, sanitising instruments after every use, and other safety measures are costing them dearly too. Many have decided to wind up practice since running their clinic in a rented outlet has become completely unaffordable.

Dr Manish Guri and his wife Dr Avani, practicing at their Ghatkopar clinic for two decades, told mid-day that COVID-19 continues to scare people. "Ninety per cent of dental work is done on dental aerosol, which according to Indian Dental Association (IDA) and Dental Council of India (DCI), should be used minimally along with high-speed drilling machines to restrict the spread of infection. This makes the situation very challenging for us," the couple said, adding that most dental clinics are in a small area of around 150 sq feet, and the guidelines insist on maintaining safe distance. There is also mandatory thermal screening, mask, head cap and gloves for patients, COVID-19 history recording, PPE kits and N95 masks for dentists, no walk-in patients, etc, which means additional expenses. "I have no choice but to shift the cost on to my patients, who have already come down from 15 a day to four in two to three days. I will have to increase my fee by almost 25 per cent." Dr Guri said. Another problem for dentists is differing guidelines from the IDA, DCI and the Ministry of Health, and Family Welfare (MOHFW). "A week before the lockdown started (March 23), we were told to only attend to emergency cases," the dentist added.

Confusing guidelines

Dr Mukund Shanbaug wearing a PPE kit inside his clinic

Dr Mukund Shanbaug, a senior dentist from Sion, said, "Dental laboratories, which dental clinics are dependent on, are facing material issues (most materials are imported) and cost escalation. A hike of around 25 per cent for the patient fees is surely on the cards."

Dr Amit Salunke standing next to his dental chair in his newly opened clinic in Kurla

Another dentist from Kurla, Dr Amit Salunke, has been paying an EMI of Rs 32,000 for his new clinic setup that he purchased in March 2020. "Most of my dentist friends have temporarily moved out of their rented clinics. We are hoping that by November, the situation will improve," said Dr Salunke who would earlier examine eight to ten patients daily. The patient count has now dropped to two to three cases a day. "With the new safety guidelines, I also had to set up safety gadgets and equipment worth Rs 50,000 at the clinic," he added.

Alternative careers

Dr Hemant Dhusia, a professor of dentistry and former dean (Academics), LTMG hospital, too expressed similar concerns, saying, "Dentists who are in a very competitive field, are incurring additional due to the new guidelines. Many dentists are contemplating giving up practice."

Professor Dr Hemant Dusia

Dr Dhusia told mid-day that nearly 80 per cent dental clinics in Mumbai and MMR region are in premises less than 150-sq-feet area where following social distance norms is difficult.

"In such challenging times, only need-based dental work can be done - pain relief or filling minor cavities. Cosmetic dentistry and implants will be witnessing a drastic slow down for at least another couple of months," he said, adding that young dental graduates were now taking up alternate careers. "An entire batch of dental graduates opted for a BPO job in a Bengaluru college while some went for MBA courses and others joined pharma companies," he said.

Fees to go up

Dr Vikas Patil, president, Indian Dental Association (IDA), Maharashtra, said, "We have 8,000 dentists registered with IDA and the number of practising dentists across the state might be 16,000. In Mumbai, IDA has 1,500 dentists and 3,500 to 4,000 might be practising in the city."

The problem, he said, is severe in red zones like Mumbai, Navi Mumbai, Thane, Pune, Pimpri-Chinchwad, Malegaon, Aurangabad etc. Dentists are operating normally in other districts while following the safety guidelines, Dr Patil said, adding that the new safety gadgets had definitely put an additional financial burden on dentists. "In COVID-hit areas, the fees are likely to go up by 25 to 30 per cent," he said, adding that IDA has a tie-up with the state government and "in almost all districts, there was a government vacancy for nearly 500 dentists at a pay scale of Rs 40,000 to Rs 60,000 during the lockdown." Many have availed the facility of working temporarily in government hospitals, he said.

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