Shifting of Dental Services to Taba and its various implications

The Dental department from Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) has been successfully shifted to Taba a few months back. According to Mr. Gyan, a Senior Dentist, to address overcrowding and a limited expansion area at the JDWNRH for the dental department, the government has taken a significant step by shifting it to Taba. This move aims to lessen the congestion of patients and pave the way for the development of a comprehensive dental institute in the future.

He clarified that many individuals often associate dental care solely with tooth extraction and fillings, while it encompasses a range of specialized branches, including endodontics (root canal treatment), oral medicine, orthodontics, prosthodontics, and gum specialization, for which enough space with adequate facilities is necessary.

Initially, there were around 34 patient visits on the first day and the numbers increased to more than 100 within a week or two. Currently, an average of 150 patients visit daily to avail of the service.

The relocation to Taba has allowed for the introduction of new and improved dental services, such as dental implants, facilitated by the availability of adequate space such as an increased number of chambers and dental chairs.

Apart from the successful shift to Taba, one of the Dental staff said that several challenges emerged initially during the office relocation. Some instruments experienced breakdowns, minor issues such as water shortages and power outages occurred, and initial malfunctions in the dental chairs were encountered. Now there is the presence of a dedicated team of biomedical experts, including carpenters, plumbers, and electricians, and timely maintenance and repairs have been effectively addressed.

Patients, however, continue to face challenges as they require cross-consultations with medical specialists. A 38-year-old patient shared her concern regarding the absence of on-site blood testing facilities at Taba Dental obligated her to visit JDWNRH for the blood- examinations and back for the proceeding consultation.

One of the 11th-grade students from YHSS said that comparing the accessibility at Taba mentioned that the previous location was within walking distance, making it convenient for students. However, the current dental hospital’s distant location poses challenges. She said, “The long distance to Taba is causing inconvenience, waiting for a bus not only makes me late for school but also delays my dental service token.”

Tenzin Choda, a 31-year-old resident of Khasadrapchu, faced a considerable financial burden when he had to accompany his father to the Taba Dental Hospital for tooth treatment. Comparing the costs, he expressed his concern over the significant increase in expenses compared to the more affordable fee of Nu.100 at JDWNRH. The journey from Khasadrapchu to Taba Dental Hospital has proven to be quite costly, with expenses exceeding Nu.200. Tenzin emphasized that JDWNRH served as a central location, making it more convenient for patients to access dental services.

It is Tenzin’s second day visiting the Taba Dental Hospital with his father, and the accumulated transportation costs have become a financial strain.

He also said that apart from the constraints, the current Hospital is specialized in Dental services, and unlike in previous hospital with diverse services, it is easier here as it is accessible and all the chambers are related to dental services.

The reporter talked to two female patients. One said, “The absence of an appointment system makes it difficult for us to plan our visit and ensure we receive timely dental care.” Another shared that she had reserved a taxi the day before, only to return home without receiving dental services due to the unavailability of tokens.

Addressing the issue, a staff member at the reception explained that the current absence of an appointment system is primarily due to weak internet accessibility and a few other factors. She further said that each dentist is allocated 25 tokens per day, the number may vary depending on the time required for each patient. To prevent patients from being turned away without receiving treatment, extra tokens are issued when necessary.

Nevertheless, the shifting has managed to reduce waiting lists for patients, although tooth complications and infections continue, ensuring a more streamlined and efficient treatment process due to the increased number of chambers and dental chairs available.

Apart from the patients, a few of the staff raised concerns regarding the long distance between Taba and other locations, such as Khasadrapchu and Babesa, which has posed an inconvenience for them, particularly those without access to private vehicles. However, the staff has been coping with the situation so far.

Some inconveniences reported by patients include difficulties obtaining tokens, Taxi charges, lengthy processes, the need to travel to JDWNRH for blood tests, and limited availability of certain medicines, which must be sourced from JDWNRH or other pharmacies. Consequently, the cost of dental services has increased for patients.

Currently, the dental department at Taba has sufficient chambers and recently introduced dental chairs. A few staff shared that there is a shortage of human resources, especially dental hygienists and dental technicians, which compromises infection control practices. Meeting standard regulations often requires a “four-hands dentistry” approach, involving two dentists and two dental assistants. With the current shortage, staff members are burdened with additional tasks, affecting infection control measures. The staff emphasizes that the existing services could be significantly enhanced and improved with an adequate number of staff.

Dentist Gyan said that this relocation might pave the way for a flourishing future. The government is hopeful for the establishment of a comprehensive dental institute with a wide range of specialists and sub-specialists. Already, dental implant services have been initiated, and there are plans for future advancements in laser surgery, advanced general practices, and oral and maxillofacial surgery. Mr. Gyan expresses optimism regarding the prospects of the dental department and its potential to provide additional and improved services.

In a question and answer session held at the National Assembly on June 23rd, Health Minister Dasho Dechen Wangmo stated on the decision to relocate the dental department from JDWNRH to Taba. The move was driven by the aim to provide comprehensive care within the dental department, according to Dasho Dechen Wangmo. She emphasized that the relocation was necessary to enhance dental services and transform it into a fully-fledged institute, as the limited space at JDWNRH posed limitations on further expansion.

Dasho Dechen Wangmo also highlighted the issue of dental employment, stating that numerous Bhutanese dentists have practicing dental clinics at Jaigoan. By shifting the dental department to Taba, the ministry sought to create employment opportunities for the dentists, fostering their growth within a developed dental department equipped with ample space for future expansion. The Ministry of Health has ambitious plans to nurture the dental facility at Taba into a reputable dental institute, expanding its services with advanced facilities and better services.

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