Public dental care falls short as demand outpaces capacity

Public hospitals in Karachi and across much of Sindh are facing significant challenges in delivering quality dental care due to a shortage of specialist dentists, outdated equipment and limited treatment capacity.

As a result, many patients are either forced to seek costly treatment at private clinics or endure long waiting periods for care.

Only a few public institutions, including Civil Hospital Karachi, Jinnah Postgraduate Medical Centre (JPMC), Jinnah Sindh Medical University (JSMU) and Dow University of Health Sciences (DUHS), have dedicated dental departments.

While JSMU and DUHS offer subsidised dental services, Civil Hospital and JPMC primarily provide outpatient consultations, tooth extractions and other basic procedures, with advanced treatments such as root canal therapy remaining inaccessible to most patients.

The situation is even more difficult in district and taluka hospitals, as well as primary healthcare centres throughout Karachi and interior Sindh, where dental units are largely absent. This leaves residents with limited access to public dental care and places additional strain on the few tertiary-care hospitals that provide these services.

Meanwhile, the high cost of private dental treatment has placed quality oral healthcare beyond the reach of many households. Consultation charges typically range from Rs2,000 to Rs5,000, while root canal procedures cost between Rs15,000 and Rs25,000. Dental fillings generally cost Rs5,000 to Rs8,000, whereas more specialised treatments—including crowns, implants and jaw surgery—can cost several hundred thousand rupees.

Public dental facilities are also constrained by inadequate infrastructure and obsolete equipment. Many departments lack modern dental chairs, endodontic instruments, digital X-ray systems, implant technology, sterilisation units, surgical tools and laboratory support. In some hospitals, dentists continue to rely on ageing surgical instruments because replacements are unavailable.

At the same time, the widespread consumption of gutka and mawa has contributed to a growing burden of oral diseases, with dentists reporting increasing cases of tooth decay, gum disease and oral cancer across Sindh.

Former Pakistan Medical and Dental Council Executive Member Dr Feroz Jahangir said that although Civil Hospital and JPMC have dental departments, they are not fully functional, forcing large numbers of patients to seek treatment in private clinics.

“Patients often question the quality and availability of equipment in public hospitals, while private clinics generally rely on disposable dental instruments. Pakistan had more than 40,000 registered dental practitioners, but thousands have emigrated for postgraduate education and better employment opportunities abroad, contributing to an acute shortage of dental specialists and technicians,” said Dr Jahangir.

He also said female students now outnumber men in many dental colleges, but many women later leave clinical practice because of social and family commitments, further reducing the active workforce.

According to Dr Jahangir, Pakistan also faces a shortage of oral and maxillofacial surgeons, leaving patients with complex jaw injuries and facial trauma with limited access to specialist treatment in the public sector. Although such services are available in private hospitals, they remain unaffordable for many patients.

He added that Pakistan depends heavily on imported dental equipment and consumables from Switzerland, the United States, Japan, Germany and China. Currency depreciation, import duties and transport costs have significantly increased the price of dental treatment.

Dr Jahangir further alleged that dental consumables are sometimes diverted from public hospitals for use in private clinics, contributing to shortages in government facilities. "Overcrowding and long waiting lists often result in patients being given appointments several months later, prompting many to seek private treatment instead."

“Pakistan has no public insurance coverage for dental care and the continued use of gutka and mawa is contributing to a growing burden of preventable oral disease across Karachi and Sindh,” he concluded.